Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is mildly enlarged but unchanged . A moderate - sized hiatal hernia is re - demonstrated . The mediastinal and hilar contours are unchanged with unfolding of the thoracic aorta again noted with diffuse atherosclerotic calcifications . Symmetric widening of the superior mediastinum is also unchanged , and may reflect mediastinal lipomatosis or enlarged thyroid . The pulmonary vascularity is not engorged . Lungs are clear without focal consolidation . No pleural effusion or pneumothorax is present . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Moderate size hiatal hernia . Persistent widening of the superior mediastinum could reflect mediastinal lipomatosis or an enlarged thyroid gland . Consider further evaluation with chest CT .