Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: An ICD is seen with leads extending into the right atrium and right ventricle . An aortic abdominal aorta stent is incidentally noted , unchanged and appearance from the prior examination . The lungs appear hyperinflated with flattening of the bilateral diaphragms . There is no focal consolidation , pleural effusion , pneumothorax , or pulmonary edema identified . The heart size is normal . A focal convexity at the left cardiomediastinal contour is see just below the left hilum , likely due to rotation . Incidentally noted are several healed right rib fractures .
    OUTPUT:
    
1 . Hyperexpanded lungs suggestive of COPD . 2 . New focal convexity of the left cardiomediastinal contour just below the left hilum , possibly due to slight patient rotation . Recommend repeating the radiograph with proper patient positioning to exclude a mediastinal mass . Findings were conveyed by Dr . ___ to the office of Dr . ___ on ___ at 11 :30 am .