Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates hyperinflated lungs . A rounded opacity projecting over the left lung apex may represent a pulmonary nodule , pleural abnormality , or may with be within the rib . The cardiomediastinal and hilar contours are unremarkable . There is no pneumothorax , pleural effusion , or consolidation . A tracheostomy is in place , ending 4 .5 cm from the carina .
    OUTPUT:
    
1 . Hyperinflated lungs . No pneumonia . 2 . Rounded opacity projecting over the left lung apex may represent a pulmonary nodule , pleural abnormality , or may with be within the rib . Recommend oblique view for additional evaluation .