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It is a mistake. The isthmus of the thyroid gland is a thin bridge across the trachea, linking the right and left lobes. It occasionally also gives rise to the pyramidal lobe, a normal variant of thyroid anatomy. The adjectival form of isthmus is isthmic, so a nodule in the thyroid isthmus is an isthmic nodule, not an isthmal nodule.

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Q: What is an isthmal nodule found in the thyroid gland?
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