Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is mildly enlarged , slightly increased when compared to the previous exam . The aorta is tortuous . There is no pulmonary vascular congestion . Fibronodular opacities within the lung apices persist , though there are least 2 new ill - defined nodular opacities noted within the right upper lobe . Calcified granuloma within the left lower lobe , superior segment is unchanged . No pleural effusion or pneumothorax is demonstrated . No acute osseous abnormalities are seen .
    OUTPUT:
    
Increased nodular opacities within the right lung apex could reflect a superimposed process on a background of chronic granulomatous disease within the lung apices . These processes could be infectious , inflammatory , or possibly neoplastic . Chest CT is suggested for further assessment .