Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen are findings suggests of COPD with increased lucency in the bilateral apices consistent with bullous change . There is a stellate opacity in the right upper lobe with associated volume loss . While this may reflect scarring , neoplastic lesion can not be excluded . In addition there are ill - defined airspace opacities of the right lung base suspicious for pneumoniae . No definite pleural effusion seen although the costophrenic angles are not fully visualized .
    OUTPUT:
    
No significant interval change when compared to the prior study . A spiculated opacity with volume loss in the right apex may represent scarring but an neoplastic lesion can not be excluded , recommend CT chest to further evaluate . Right basal consolidation .