Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided demonstrate dual - lead pacer in unchanged position . The lung volumes are low . A rounded hyperdense nodule projecting over the right lung base represents calcified granuloma as seen on prior CT . Patient is known to have severe emphysema . There is no convincing sign of pneumonia or CHF . No large effusion or pneumothorax is seen . The cardiomediastinal silhouette appears stable . Bony structures appear intact .
    OUTPUT:
    
No acute findings . Emphysema noted .