Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is mildly enlarged . There is a dexropositioning of the heart and mediastinal structures . The heart is moderately tortuous . Calcifications are noted in the arch . There is marked dilatation of the esophagus with air - fluid levels that are prominent along the right upper lateral margin of the mediastinum as well as a large gas bubble protruding into the base of the neck . Aside from a patchy associated right mid lung opacification suggesting minor atelectasis or scarring , the lungs appear otherwise clear . There is no definite pleural effusion or pneumothorax . Mild hyperinflation is present . The bones appear demineralized . There is minimal loss in vertebral body height along the mid thoracic spine .
    OUTPUT:
    
Markedly dilated esophagus with air - fluid levels , as well as large gas bubble protruding into the base of the neck . This appearance could be seen with achalasia , although the exact role of the bubble in the neck is uncertain . Correlation with clinical history is recommended with consideration of further imaging if needed clinically particularly if the anatomy is not already understood .