Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is again moderately enlarged . The descending aortic contour is again tortuous and there is dilatation of the aorta . In addition , the mediastinum appears wider on the right side than previously seen as well as mildly lobulated . This appearance could be associated with new lymphadenopathy or even a mass in the mediastinum versus primarily increase in the size of the aorta . The lung fields appear clear . There are no pleural effusions or pneumothorax . Mild compression deformities are similar along the mid - to - lower thoracic spine . These include a moderate anterior wedge compression deformity at the thoracolumbar junction that appears similar .
    OUTPUT:
    
1 . No evidence of acute disease , including pneumonia or congestive heart failure . 2 . Abnormal mediastinal contour including enlarged aorta and increased apparent lobular widening of the right mediastinum . Although the technique is different , this appearance raises concern for lymphadenopathy , mass or possibly increasing aortic aneurysm . Evaluation with chest CT is recommended when clinically appropriate , preferably with intravenous contrast .