Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is rotated positioning . Probable background COPD . Mild cardiomegaly , with calcified slightly unfolded aorta . There is slight upper zone redistribution , but I doubt overt CHF . There is atelectasis the left lung base , without definite consolidation . No gross left effusion . There is hazy obscuration of the right lung base raising the question of a small effusion and / or atelectasis . No definite consolidation . Due to patient rotation , the previously seen large right - sided thyroid mass , possibly a goiter , which compresses and displaces the trachea , is less well delineated , but probably similar to the prior study . Known recent fracture of the left anterior second rib is not well depicted radiographically .
    OUTPUT:
    
Hazy opacity at the right lung base may represent a combination of a small amount of pleural fluid and / or atelectasis . Some patchy retrocardiac opacity is also present . No definite consolidation is identified at either lung base , though an early infiltrate would be difficult to completely exclude in either location . Doubt focal consolidation in the mid or upper zones . Hazy opacity in the right paratracheal . Region is from double with the previously demonstrated large right thyroid mass , question goiter . Mild cardiomegaly and and COPD . Mild vascular plethora , but doubt overt CHF . Known left anterior second rib fracture not well visualized .