Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . There is elevation of the hila likely secondary to scarring from prior radiation . Both apical pleural margins are severely thickened , right greater than left . There is a subtle increase in opacity in the retrocardiac region . There is no large pleural effusion or pneumothorax . The tracheostomy tube projects appropriately over the midline on the frontal view , however evaluation is limited on the lateral view .
    OUTPUT:
    
Tracheostomy tube projects appropriately over the midline trachea on the frontal view , however evaluation is limited on the lateral view . Additional imaging of the lateral view of the neck or an augmented lateral view may be helpful for further evaluation . Updated recommendation was submitted to the ___ nurse by Dr . ___ on ___ .