Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . The mediastinal and hilar contours unchanged . Bilateral hilar and prevascular mediastinal lymphadenopathy are better assessed on the previous PET - CT . Pulmonary vasculature is not engorged . A fiducial marker is noted within a spiculated lesion in the right medial apex of the lung compatible with known malignancy . No new focal consolidation , pleural effusion or pneumothorax is present . Lungs are hyperinflated with emphysematous changes again noted . No acute osseous abnormalities detected .
    OUTPUT:
    
No new focal consolidation to suggest pneumonia . Re - demonstration of spiculated right apical lesion and emphysema .