Patient: asymptomatic, found during a physical examination in November this year. Ultrasound findings: right lobe thyroid gland size 46*19*14MM left side thyroid gland size 42*18*12MM isthmus diameter thickness 2MM ultrasound features: bilateral thyroid gland size and morphology normal, regular margins, parenchymal echogenicity is not uniform, several small hypoechoic masses of different sizes can be seen, the largest one is located in the middle of the right thyroid gland, size about 13*8MM, irregular margins, internal echogenicity. The largest mass was located in the middle part of the right thyroid gland, with a size of about 13*8 MM, irregular margins and uneven internal echogenicity. The left thyroid masses were small, the largest one was about 6*3MM in size, with irregular margins and heterogeneous internal echogenicity. The isthmus was not thickened. CDFI: No abnormal color flow signal was seen in the thyroid parenchyma. No enlarged lymph node echogenicity was detected in the neck. Diagnostic findings: nodular goiter. No lymph node enlargement was seen in the neck. No treatment. 1. Is this condition a distention? Is it malignant or benign? 2. Is surgery required? If surgery is performed, is the thyroid gland completely removed because it is bilobed and multifocal? 3.If not, what is the treatment? What medication can be taken to control or reduce it? 4.If surgery is not required, how often should I be examined and what kind of tests should be done? This case is temporarily considered as a nodular goiter, which can develop into hyperthyroidism and has a certain chance of malignant change, but the probability is small.