Thyroid 4b nodule has not developed for 4 years, you can continue to review, you can also perform a puncture pathology analysis of the thyroid nodule, if malignant need surgical treatment. The degree of malignancy of thyroid 4b nodule is about 10%~50%, thyroid nodule has not developed for a long time, you can continue to review, you can also carry out thyroid puncture biopsy, if benign continue to observe and review can be, half a year to review the thyroid ultrasound. If the nodule is malignant, thyroidectomy and peripheral lymphatic drainage should be performed depending on the size of the nodule and the surrounding lymphatic metastasis. Thyroid nodules category 4b need to be treated under the guidance of a doctor.