Us shows multinodular thyroid (.6 cm, .4 cm)goiter but predominate solid nodule is 3.2cm has new calcific and increased vascularity what does this mean?

Needs further workup: Any nodule over 1cm should undergo at the very minimum a fine needle aspiration biopsy. A recommendation may also be made to bypass the needle biopsy and proceed to thyroidectomy given the new calcifications which place the nodule in a higher risk category. Discuss these and other options with your primary care physician and/or specialist.