Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and bilateral hilar enlargement are consistent with lymph node enlargement related to known CLL . They appear unchanged since the prior radiograph . Patchy and linear opacities have developed at both lung bases , as well as an apparent nodular opacity in the left mid - to - lower lung region at the level of the fifth anterior rib at the intersection with the ninth posterior rib . Small bilateral pleural effusions are new , left greater than right . No acute skeletal abnormalities .
    OUTPUT:
    
1 . Questionable left lung nodule versus superimposition of normal structures . Considering history of neutropenic fever , ___-degree shallow oblique radiographs or CT may be helpful to further evaluate this region to exclude the possibility of a fungal infection if warranted clinically . 2 . Small bilateral pleural effusions , left greater than right . 3 . Mediastinal and hilar lymph node enlargement , consistent with known history of CLL . Findings and recommendation discussed by phone with Dr . ___ on ___ at 10 :45 am at the time of discovery .