Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear within normal limits . The lungs appear clear . There are no pleural effusions or pneumothorax . There is a nodular opacity projecting over the left apex that appears more prominent than on the prior radiographs , although it is difficult to compare to the more recent prior CT . Although it had not substantially changed since the earlier CT , an apparent change in radiographic appearance is noted , so a followup chest CT is recommended . Elsewhere , the lungs remain clear .
    OUTPUT:
    
1 . No evidence of acute disease . 2 . Apparent increase in left apical nodular opacity since prior radiographs . Although the finding had been noted as stable by a chest CT over nearly a year , since that time , given apparent radiographic increase , a repeat chest CT is recommended when appropriate to evaluate further .