Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Redemonstrated are biapical scarring and a calcified right middle lobe granuloma . There has been interval progression of the right lower lobe volume loss , with associated pleural thickening and effusion . A small left - sided pleural effusion is noted as well . The left lung is grossly unremarkable . The heart size is at the upper end of normal . Compared to the prior examination , the trachea is somewhat more deviated towards the right .
    OUTPUT:
    
Interval progression of right lower lobe opacification , with associated pleural thickening , effusion and volume loss . Recommend Chest CT examination for further evaluation . Findings were conveyed by Dr . ___ to Dr . ___ ___ telephone at 4 : 35 pm on ___ , 5 minutes after discovery .