Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , consistent with severe emphysema . A poorly defined nodular seen in the right lung apex , is again demonstrated and is possibly slightly increased in size in the interval . Lungs are otherwise clear . No pleural effusion or pneumothorax . The cardiomediastinal silhouette is unremarkable .
    OUTPUT:
    
Nodular opacity in the right lung apex has apparently increased in size since ___ but is difficult to assess radiographically due to overlapping osseous structures . Recommend CT for further assessment .