Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . There is severe bullous emphysema on the right . Increased ill - defined opacification in the right upper lung is new from prior with focal lateral pleural thickening in this region . An air - fluid level is noted in a large bulla adjacent to the region of consolidation . The left lung is grossly clear . Cardiomediastinal silhouette is normal . No pulmonary edema or pleural effusion is present . There is no pneumothorax .
    OUTPUT:
    
Focal consolidative opacity in the right upper lobe with associated pleural thickening and fluid in an adjacent bulla , findings which favor infection however a followup chest radiograph in ___ weeks after treatment is recommended to exclude underlying malignancy . If there are continued persistent abnormalities on the follow - up radiograph , chest CT is recommended .