Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is not enlarged . The thoracic aorta remains widened with calcium deposits in the wall at the level of the arch . Again noted is a small density in the left mid lung zone which has increased in size compared to the prior exam . There remains irregular distribution of peripheral pulmonary vasculature and flattened diaphragms typical for COPD .
    OUTPUT:
    
Interval increase in size of left mid lung zone nodule . Especially given underlying COPD , CT scan is recommended for better characterization .