Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is status post sternotomy . Sutures are midline and intact . Additional postoperative changes evident in the right upper lung with chain sutures and relative lucency at the apex consistent with reported resection . Three additional surgical clips project over the right upper mediastinum . An additional 2 mm metallic density is in close proximity to this region and likely represents a surgical clip viewed on end ; however , without a lateral view to confirm , shrapnel related to known gunshot wound is not excluded . No focal opacification concerning for pneumonia . Cardiac silhouette is enlarged . Mediastinal and hilar contours are otherwise unremarkable . Faint asymmetry of lung base opacifications is likely related to scoliosis .
    OUTPUT:
    
Post - traumatic and surgical changes noted in the right upper lung with a 2 mm metallic density likely representing a surgical clip viewed on end , but can not exclude shrapnel related to gunshot wound . Recommend conventional frontal and lateral radiographs . Cardiomegaly .