Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . The lungs are hyperinflated , as before , and there is increased AP diameter of the chest , consistent with a history of COPD . The right hemithorax is slightly smaller than the left , unchanged . Heart is mildly enlarged , but cardiomediastinal contour is stable . Prominence of the right pulmonary arttery is again seen . There is a small right effusion , perhaps very slightly improved , with some underlying atelectasis . Scarring and volume loss in the right middle lobe appears stable . Again seen is a large irregular density projecting over the right lower lung which corresponds to a large unusual branching calcification or other density in the right breast ( 2 :31 on ___ CT ) . MInimal blunting of the left posterior costophrenic angle and minimal left base atelectasis / scarring is unchanged . No new infltrate is detected . No obvious ptx . No chf . Degenerative changes are again noted in the thoracic spine . There has been interval removal of the right chest tube .
    OUTPUT:
    
COPD and cardiogemaly . RML scarring and volume loss . Small right effusion and possible tiny left effusion . Howver , no significant interval change detected compared with ___ . No new infiltrate , chf , or obvious pneumothorax .