Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild enlargement of cardiac silhouette is re - demonstrated with a moderate size hiatal hernia again noted . Atherosclerotic calcifications of the aortic knob are present . Mediastinal contours are otherwise unchanged , and the hilar contours are within normal limits . New focal patchy opacity is noted within the periphery of the left upper lung field , with re - demonstration of clusters of nodules within the right upper lobe and left lower lobe , as seen on the prior CT from ___ . No pleural effusion , pulmonary vascular congestion or pneumothorax is seen . There are mild degenerative changes in the thoracic spine .
    OUTPUT:
    
New peripheral patchy opacity within the left upper lung field which could reflect an area of infection or inflammation . Pulmonary infarct also can not be excluded . Unchanged clusters of nodules within the right upper lobe and left lower lobe , as seen on the previous exams , which may be due to chronic infection or inflammation .