Thyroid Multinodular Goiter - Heterogeneous

A 55-year-old woman from a sub-Himalayan region presents with a 10-year history of slowly progressive anterior neck swelling. She is clinically euthyroid. Ultrasound shows the structure marked **A** (heterogeneous multinodular thyroid) with bilateral diffuse enlargement and multiple nodules of varying sizes. A dominant 2.8 cm nodule in the right lobe is solid, hypoechoic, taller-than-wide, with microcalcifications and ill-defined margins, scoring ACR-TIRADS 5. Based on the sonographic features of the dominant nodule within this heterogeneous multinodular pattern, which of the following is the most appropriate next management step?