Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been previous median sternotomy . Cardiac silhouette is enlarged but stable in size . Aorta is diffusely tortuous and both the ascending and descending regions . Enlargement of central pulmonary vasculature suggestive of pulmonary arterial hypertension . In addition to these vascular findings , cardiomediastinal widening is in part due to excessive mediastinal fat deposition , mediastinal lipomatosis . Apparent sub cm nodular opacity is present in the right upper lung at the intersection of the right third anterior and seventh posterior ribs . Of note , a smaller nodule was present in this region on older chest CTA of ___ . Lungs are hyperexpanded but grossly clear except for linear scarring at the bases . Bones are diffusely demineralized . Healed right rib fractures are again demonstrated .
    OUTPUT:
    
Findings consistent with COPD and probable pulmonary arterial hypertension . Stable cardiac enlargement without evidence of congestive heart failure . Possible small right upper lobe lung nodule , for which chest CT is recommended for confirmation and further characterization .