Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours are unchanged . The pulmonary vascularity is not engorged . Rightward deviation of the upper trachea is secondary to a known left sided thyroid nodule . Ill - defined right middle lobe opacity correlating to a known spiculated nodule with adjacent scarring is similar to the prior radiograph and is better depicted on the prior CT . No new areas of focal consolidation , mass lesion , pleural effusion or pneumothorax are present . There are no acute osseous abnormalities . Multilevel degenerative changes are noted within the thoracic spine .
    OUTPUT:
    
1 . Right middle lobe ill - defined opacity compatible with known carcinoid pulmonary metastasis . No new areas of focal consolidation or mass lesions identified . 2 . Rightward deviation of the upper trachea due to known left sided thyroid nodule .