The thyroid gland is located in front of the trachea in the neck of the body, like a butterfly attached to the trachea and covering both sides of the trachea with its wings in an elegant manner, forming the left and right lobes of the thyroid gland. The thyroid nodules are like flaws on the butterfly and can be located in any part of the thyroid, large or small, forming a discordant note that affects people’s state of mind. However, everything in this world is not perfect, so it is forgivable to have a flaw in the white jade. According to epidemiological survey data, the incidence of thyroid nodules in the population reaches 4% to 7%, and according to the results of autopsies, the incidence of thyroid nodules in people over 50 years of age reaches 50%, and more in people over 80 years of age, reflecting the fact that thyroid nodules are also increasing with time. The incidence of malignant tumors in thyroid nodules is less than 1% To understand thyroid nodules, we must first understand the thyroid gland. The function of the thyroid gland is to produce thyroid hormones and to ensure a certain level of stock, while thyroid hormones ensure that the body’s metabolism proceeds normally. When thyroid hormones are produced in excess, the body’s metabolism speeds up, resulting in rapid breathing, heartbeat and sweating, called hyperthyroidism; conversely, when the supply is insufficient, the body’s metabolism slows down, resulting in coldness, drowsiness and rough skin, called hypothyroidism or hypothyroidism. Therefore, this “butterfly” is not only elegant in appearance, but its role is also not to be underestimated. For thyroid nodules, we are concerned about the nature of the “defect”: if it is a white flaw, we do not have to destroy it, understanding that perfection is relative; but if the “defect” is a malignant tumor, then we will not hesitate to The “flaw” is a malignant tumor, and we will not hesitate to ask the surgeon to come out and remove the thyroid gland to save the day. Of course, fortunately, the incidence of malignancy in thyroid nodules is less than 1%, so the identification of various “defects” is crucial. Unfortunately, there is no means to identify 100% whether it is benign or malignant, which leaves us with a combination of tests to determine. First of all, we can easily check whether a thyroid nodule is solitary or multiple, and modern ultrasound is more than adequate for this purpose. In the past, it was thought that multiple nodules were benign, while single nodules required more vigilance. However, it is now believed that the two must be considered together and that multiple nodules should not be taken lightly. Any nodule larger than 1 cm must be taken seriously and further measures must be taken. Checking the function of the nodules is also a very important item. On the one hand, a blood test for thyroid hormones is a quantitative indicator of thyroid function, while in some cases nuclear imaging is also of great value to determine function. If it is a single hot nodule, the likelihood of malignancy is very low; if it is a cold nodule, although it is only about 20% likely to be malignant, once the ultrasound suggests any hint of malignancy such as hypoechogenicity, microcalcifications or irregular margins, it is often necessary to perform a puncture test or simply adopt a “better to kill a thousand wrongly than to miss one The policy of “better to miss one than a thousand. In many cases, the test results will suggest that the thyroid nodules are multiple, irregular in size, normal in function, and very hesitant to be treated. As the saying goes, “a flaw does not cover up a weakness,” and it is a bane to dismember this beautiful “butterfly” without sufficient evidence. At this point, we often need time to observe: we continue to check the condition of the nodule with ultrasound after two or three months, and if there is a significant increase in size, “shoot to kill”. In many moments of indecision, we have another killer feature: fine needle aspiration. Modern technology has made ultrasound-guided needle aspiration a very sophisticated technique, and the pathology removed will determine the nature of the nodule and the fate of the “butterfly”. However, despite the considerable technical sophistication of pathology, there are still a small number of nodules that cannot be distinguished as benign or malignant. Therefore, it is important for everyone suffering from a thyroid nodule to work closely with their doctor.