Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderately enlarged cardiomegaly and massively dilated bilateral pulmonary artery , consistent with pulmonary arterial hypertension , are unchanged in severity since prior radiograph . No pleural effusion or pneumothorax . Ill - defined nodule in the right upper lung measuring 1 .3 x 1 .4 cm has grown since ___ when it was seen as a very inconspicuous opacity . This nodule should be further evaluated with chest CT to rule out a possibility of lung malignancy . Degenerative changes are seen at multiple thoracic vertebral levels . Mediastinal contour is unchanged .
    OUTPUT:
    
1 . An irregular spiculated nodule of 1 .2 x 1 .3 cm in the right upper lung has grown since ___ when it was highly inconspicuous . Chest CT is recommended for further evaluation . 2 . Moderate cardiomegaly and enlarged bilateral pulmonary arteries suggestive of pulmonary artery hypertension . Findings were discussed with Dr . ___ ___ the significance of this nodule , and recommendation of chest CT on ___ at 4 :36 p .m .