Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and hilar contours are unchanged with rightward shift of mediastinal structures again noted . There is similar elevation of the left hemidiaphragm with mesh material projecting over the diaphragmatic contour . Post thoracotomy changes are again noted on the left with chain sutures seen in both lung apices . The pulmonary vasculature is not engorged . Bullous emphysematous changes are re- demonstrated , with the largest bulla seen at in the right lung base . Unchanged linear opacities in both upper lobes likely reflect areas of scarring . No new focal consolidation , pleural effusion or pneumothorax is present . There are no acute osseous abnormalities .
    OUTPUT:
    
No interval change from the previous exam without new acute cardiopulmonary abnormality .