Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe enlargement of the cardiac silhouette is re - demonstrated , with dense atherosclerotic calcification of the aortic arch again noted . The mediastinal and hilar contours are otherwise stable with dilatation of the ascending aorta and tortuosity of the thoracic aorta . The pulmonary vasculature is not engorged . Emphysematous changes are again noted within the upper lobes . Patchy retrocardiac opacity likely reflects atelectasis , but infection can not be completely excluded . Scarring within the lung apices is stable . Linear opacities within the right mid lung field also appear relatively unchanged and appear compatible with scarring / post radiation changes . There may be trace bilateral pleural effusions . No pneumothorax is present . Multilevel degenerative changes are again seen within the thoracic spine , without an acute osseous abnormality seen . Clips are noted within the right chest wall , compatible with prior lumpectomy .
    OUTPUT:
    
Patchy retrocardiac opacity may reflect atelectasis but infection is not excluded . Possible trace bilateral pleural effusions .