Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . The aorta is markedly tortuous with fusiform dilatation of the descending thoracic aorta better assessed on the prior CT . Hilar contours are similar . Extensive emphysematous changes are again noted . Right apical mass is grossly unchanged . Mild pulmonary vascular congestion is new in the interval . No new focal consolidation , pleural effusion or pneumothorax is present . Patchy atelectasis is seen within the right lung base . There are no acute osseous abnormalities .
    OUTPUT:
    
Mild pulmonary vascular congestion . Severe emphysema with unchanged right apical mass .