Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Overall , no significant change is seen with severe emphysema again noted . There has been prior resection of the left upper lobe which accounts for the left apical cap and the slight upward retraction of the left hilum . A subtle nodular opacity is seen projecting over the left mid to upper lung which measures approximately 18 mm , and is better characterized on the prior CT chest dated ___ . No superimposed pneumonia , effusion or pneumothorax . Cardiomediastinal silhouette is stable . Bony structures are intact .
    OUTPUT:
    
Stable appearance of the chest with severe emphysema , left upper lung nodule . No superimposed pneumonia .