Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large rounded opacity projecting over the left mid lung , measuring approximately 6 .4 x 4 .3 cm . Additionally , there is a right perihilar opacity , the medial portion of which is not well assessed , but which measures approximately at least 2 .5 x 2 .7 cm . There is mild left base atelectasis / scarring . No large pleural effusion is seen although trace pleural effusion will be difficult to exclude . The aorta is calcified and tortuous . The cardiac silhouette is not enlarged . The patient is rotated slightly to the left . There may also be a subtle opacity projecting over the anterior right fourth rib . There is mild elevation of the left hemidiaphragm .
    OUTPUT:
    
At least two rounded opacities , one projecting over the left mid lung measures 6 .4 x 4 .4 cm and one in the right perihilar region measuring 2 .5 x 2 .7 cm . Findings are highly worrisome for malignancy . There may be a second smaller focus of opacity projecting over the right anterior fourth rib . If patient does not have known pulmonary malignancy , recommend nonurgent chest CT with contrast for further evaluation . Patient has two medical record numbers . Patient has history of lung malignancy with rounded opacities increased in size since the prior study worrisome for progression of disease .