Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear . Heart size is normal . A round density overlying the right tracheobronchial angle is unchanged compared to exams dating back through ___ and is probably a large costovertebral osteophyte or benign expansion of a vertebral transverse process . There are no pleural abnormalities . Multilevel degenerative changes of the thoracic spine are noted . A very dilated left piriform sinus is probably of no clinical significance .
    OUTPUT:
    
No acute cardiac or pulmonary process .