A 32-year-old female patient with a family history of autoim…

A 32-year-old female patient with a family history of autoimmune hypothyroidism presents to the ultrasound department for a thyroid sonogram. The patient has a history of progressive thyroid enlargement and worsening hypothyroidism. The sonographer identifies an enlarged, inhomogeneous thyroid gland. Which of the following could the patient have, based on the information given?