Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Persistent but improved patchy opacities in the right upper and middle lobes since ___ . Persistent tenting of the right and right hemidiaphragm may reflect pleural thickening and / or scarring , sequelae of prior infection or process causing volume loss such as fibrotic changes . There is trace fluid in the minor fissure , which is elevated , suggesting significant right upper lobe volume loss or untold history of prior lung resection , although suture material is not visualized . Rounded opacity in the right hilum persists . Severe emphysematous left upper lobe predominant changes persist with flattening of the hemidiaphragms . No left pleural effusion . No pneumothorax . The descending thoracic aorta is tortuous , unchanged . The heart is normal in size .
    OUTPUT:
    
1 . Persistent but interval improvement in right upper lobe predominant opacities with evidence of significant volume loss . Chest CT is recommended to further evaluate given the lack of complete resolution of radiographic findings . 2 . Background emphysema .