Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged . The pulmonary architecture is irregular and attenuated , particularly in the right upper lobe , suggesting emphysema . There is no pleural effusion or pneumothorax . There are patchy new opacities in both lower lungs , more confluent on the right than left side , worrisome for pneumonia , which can have an atypical appearance in the setting of emphysema . The appearance includes a nodular focus projecting over the right lower lung of about a centimeter in diameter , although possibly a nipple shadow superimposed on a background opacification in the lower lungs . Projecting over the medial left lung apex is a newly apparent pleural thickening , which was not seen before and raises potential concern for malignancy at that site . It is noted that the prior radiographs were obtained with a very similar orientation and the opacity appears new .
    OUTPUT:
    
Patchy lower lung opacities suggesting pneumonia . Findings worrisome for a new potentially malignant nodule at the left lung apex . Chest CT is recommended to evaluate further as well as consideration of a PET depending on the CT findings . A nodular focus projecting over the right lower lung should also be assessed at that time , and may reflect a true lung nodule versus part of a suspected coinciding infectious process or nipple shadow . Findings concerning for malignancy and recommendation for chest CT discussed with Dr . ___ at 3 : 20 pm by telephone on ___ .