Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right middle lobe opacity with volume loss causing shift of the minor fissure is more pronounced on today 's exam and best appreciated on the lateral view . The lungs are otherwise clear except for unchanged appearance of asymmetrical biapical pleural and parenchymal scarring , right greater than left . No pulmonary edema or pleural effusion . No pneumothorax . Moderate cardiomegaly persists and is without change . The tortuous descending thoracic aorta is also overall unchanged . The pulmonary arteries are prominent but not enlarged . Moderate degenerative changes of thoracic spine with anterior osteophytes are unchanged .
    OUTPUT:
    
Interval increased prominence of right middle lobe opacity , suggesting possible chronic middle lobe syndrome with or potentially chronic MAC infection - follow - up with short - term radiographs or chest CT could be performed if warranted clinically .