Thyroid nodule 4a has a malignancy rate of 2% to 10%, it is not necessary to do surgery, it is necessary to clarify the nature of the thyroid nodule, if the nodule is benign it can be done without surgery, regular review can be done, if it is a malignant nodule it is usually necessary to do surgery to remove it. Thyroid nodule grade 4 is suspicious of malignancy, in which nodule 4a is low suspicious of malignancy, malignancy rate 2% to 10%, can be clear through puncture biopsy nodule benign or malignant. If the lesion is benign and the size of the nodule is small, generally do not need to do surgery, should go to the hospital regularly to do review, and keep observing the change of the condition. If the nodule is malignant, you need to go to the hospital as soon as possible, and cooperate with the doctor to use surgical resection and other methods of treatment. Thyroid nodule 4a patients are recommended to seek timely medical treatment.