Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA upright and lateral chest radiograph demonstrates no focal consolidation . There is severe emphysema . As seen on prior study dated ___ , a transvenous right atrial and right ventricular pacer is identified in unchanged position . There persists vascular engorgement as well as lobulation of the left hilus for which adenopathy can not be excluded . No large pleural effusion is identified . No acute osseous abnormality . Aortic arch calcifications incidentally noted .
    OUTPUT:
    
Vascular engorgement stable since prior examination . Prominent left hilus , present on prior examination suspicious for adenopathy . A non-urgent dedicated CT for further evaluation should be obtained for further evaluation . Updated impression and recommendation was reported to Dr . ___ by Dr . ___ ___ telephone at 9 : 25 on ___ .