NRAS and adenoma: For the ≥4-cm group, where 23% (31/137) overall were malignant, there was only one malignant NRAS mutation positive nodule≥4-cm (33% (1/3) mutation positive), and the statistical impact of molecular testing to detect malignancy (p = 0.6822), adenoma (p = 0.2250) or neoplasm (p = 0.2197) was not demonstrated (Table 2).