Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged including mild cardiomegaly and calcification along the aortic arch . The central pulmonary vascularity shows upper zone redistribution with distinct but prominent vessels , similar to prior findings , suggesting pulmonary venous hypertension without congestive heart failure . A small hyperdense nodule projecting over the right mid lung is unchanged and suggests a granuloma . There is similar mild relative elevation of the right hemidiaphragm . There is no pleural effusion or pneumothorax . The patient is status post right shoulder hemiarthroplasty . Flattening and sclerosis have progressed along the left humeral head with corresponding effacement of the glenoid appears worse ; findings could be seen with a history of avascular necrosis in the appropriate setting .
    OUTPUT:
    
No evidence of acute cardiopulmonary disease . Increased flattening of the left humeral head , although likely a chronic process , possibly avascular necrosis .