Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . Atelectatic changes are again noted within the right middle lobe , similar compared to the prior exam . No pleural effusion or pneumothorax is present . The heart size is normal . Mediastinal and hilar contours are unremarkable . There is no pulmonary edema . No acute osseous abnormalities demonstrated .
    OUTPUT:
    
Persistent right middle lobe atelectasis . Pneumonia is not excluded . A chest CT should be considered for further assessment to exclude an underlying obstructive endobronchial lesion .