Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright view of the chest . Patient is known to have severe emphysema . Tiny nodular opacities are seen projecting over the mid to upper lungs , possibly representing calcified granulomas . There is a biapical irregular opacity likely scarring though on the right the overall opacity appears increased . No definite signs of pneumonia or overt CHF . No large effusion or pneumothorax . Cardiomediastinal silhouette is normal . Bony structures are intact . No free air below the right hemidiaphragm .
    OUTPUT:
    
Emphysema with increasing opacity at the right lung apex which may represent scarring though given underlying emphysema , a nonemergent CT is recommended to further assess for the presence of lung nodule .