Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient has known pathologic diagnosis of pulmonary carcinoid . Patient also has known emphysema . Multiple bilateral lung nodules predominantly in the lower lobes better appreciated on past CT . No focal consolidation . No pleural effusion or pneumothorax is seen . Mild cardiomegaly . Mediastinal contours unremarkable . . Sagittal elongation of upper trachea likely due to goiter and narrowing of lower trachea likely due to chronic cough .
    OUTPUT:
    
Sagittal elongation of upper trachea likely due to goiter and narrowing of lower trachea likely due to chronic cough . Multiple bilateral pulmonary nodules consistent with known pulmonary carcinoid better seen on previous CT . Mild cardiomegaly