Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube tip terminates approximately 4 cm from the carina . Orogastric tube courses through the stomach , with tip off the inferior borders of the film . The heart size is normal . The mediastinal and hilar contours are unremarkable . The lungs appear hyperinflated with severe emphysematous changes . A right apical area of opacification is noted , and a focal mass can not be excluded . No pleural effusion or pneumothorax is identified . There are no acute osseous abnormalities . Cervical spinal fusion hardware is not completely assessed .
    OUTPUT:
    
1 . Endotracheal and orogastric tubes in standard positions . 2 . Right apical opacity for which correlation with CT is recommended as finding may reflect a neoplasm . Severe emphysema .