Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . There is new lobular thickening of the right upper mediastinum and also a nodular appearance to the right hilum . Widespread opacity is present in the right middle lobe . Elsewhere , the lungs appear clear . There is no pleural effusion or pneumothorax . Minimal degenerative changes are noted along the mid thoracic spine .
    OUTPUT:
    
Widespread right middle lobe opacity worrisome for pneumonia , but a post-obstructive pneumonitis should be considered , noting abnormal contours of the right upper mediastinum and right hilum . Evaluation with chest CT , preferably with intravenous contrast , is recommended to evaluate further to consider the possibly of coinciding malignancy .