Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with coarse reticular markings can be smoking related lung disease . Nodular opacities right apex with slight volume loss are incompletely assessed . Additional nodular opacity in the right middle lobe likely calcified granuloma . Mild bilateral apical thickening . Heart size is normal . No pleural effusion or pneumothorax .
    OUTPUT:
    
Nodular opacities in the right upper lobe incompletely assessed could represent impacted bronchus , apical scar or lung malignancy and should be correlated with prior air chest imaging if available and CT scan of the thorax to exclude malignancy . Emphysema .