Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a dual - lead pacemaker / ICD device in place , as before . The cardiac , mediastinal and hilar contours appear stable including mild cardiomegaly . Flattening of hemidiaphragms suggest hyperinflation . There is no pleural effusion or pneumothorax . A small calcification projecting over the right upper lobe suggests a parenchymal granuloma , not significantly changed . Otherwise , the lungs appear clear . Moderate anterior osteophytes are noted along several lower thoracic levels , as before .
    OUTPUT:
    
No evidence of acute cardiopulmonary disease .