“Thyroid nodule grade 4A” generally means that the thyroid nodule is classified as grade 4A under ultrasound. Whether a thyroid nodule grade 4A requires surgery depends on the size and nature of the nodule, etc. If it is a benign and asymptomatic nodule, it is usually followed up for observation, but if it is a malignant one or one with compression symptoms, it may require surgical treatment. Clinically, when thyroid nodules are diagnosed as category 4A by ultrasound, they have a certain possibility of malignant transformation, and the chance of malignant transformation may reach about 2%~10%. Fine needle aspiration of the thyroid gland can be performed to determine the nature of the thyroid nodules first. Based on the pathology results of the fine needle aspiration of the thyroid gland, the degree of benignness or malignancy of the thyroid nodule can be initially determined, and if necessary, it can be surgically removed, and then the nature of the thyroid nodule can be evaluated based on the pathology of the thyroid nodule after the surgery. Patients with thyroid nodule category 4A are recommended to consult a regular hospital.