Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . There is a bulging contour in the aortopulmonary window that appears more prominent than on the prior study but probably the apparent difference is due to differences in technique . This appearance could be seen with an enlarged main pulmonary artery , but when clinically appropriate , CT is suggested to exclude a mass lesion . Concordant with this concern is slight apparent density projecting over the subcarinal region which is a finding that may reflect lymphadenopathy . There is no pleural effusion or pneumothorax . The lungs appear clear . Moderate osteophytes are noted along the mid - to - lower thoracic spine .
    OUTPUT:
    
Bulging contour in the aortopulmonary window , most likely due to enlargement of the main pulmonary artery or somewhat unusual course , but in order to exclude lymphadenopathy , chest CT is suggested when clinically appropriate , including with intravenous contrast administration if possible . Findings and recommendations discussed with Dr . ___ at 11 :30 am on ___ by telephone .