Thyroid 4a nodule biopsy for malignancy need to remove part or all of the thyroid gland, some have hyperthyroidism medication is ineffective and pressure symptoms also need to remove part of the thyroid gland, the specific treatment recommended to consult a doctor. The classification of thyroid nodules (TI-RADS classification) is based on the assessment of the risk of the nodule being benign or malignant on the basis of ultrasound and other imaging tests. 4a nodules are considered to be of low suspicion of malignancy, with a 2-10% chance of being malignant. If an abnormality occurs, fine needle aspiration of the thyroid is recommended to clarify the benign or malignant nature of the diseased tissue. Those who have a benign biopsy and those who do not need a biopsy may choose to be treated according to their symptoms. Asymptomatic patients can be followed up, and those with symptoms of hyperthyroidism or hypothyroidism can be treated with drugs such as methimazole or levothyroxine. If the nodule is too large and causing pressure or cosmetic problems, surgery can be performed to remove the nodule. If the biopsy is malignant, surgery should be chosen according to the type of pathology. Generally, lobectomy is feasible for differentiated thyroid cancer, while medullary carcinoma patients need total or subtotal thyroidectomy. It is recommended that patients should consult the doctor in time for histologic examination to further clarify the nature of the nodules and choose the appropriate treatment under the doctor’s guidance.