Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Chest , AP and lateral . The lungs are hyperinflated . There is nodular opacity in the right upper lobe , unchanged from the prior study . Also , there is a possible pleural contour on the right which may indicate a small right apical pneumothorax . There is increased opacity in the left lower lobe . Thickening of the right paratracheal stripe is unchanged . The heart size is normal and the aorta is unfolded . There is no pleural effusion . Pulmonary vascularity is normal .
    OUTPUT:
    
1 . Possible small right apical pneumothorax . Repeat upright radiograph with inspiratory / expiratory views is recommended . 2 . Increased opacity in the left lower lobe may represent atelectasis , aspiration , or pneumonia , depending on the clinical context . 3 . Hyperinflation of the lungs , consistent with COPD . 4 . Nodular opacities in the right upper lobe , unchanged from the prior study .