Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size remains mildly enlarged . Right paratracheal mediastinal widening is compatible with known underlying lymphadenopathy . Hilar contours are unchanged and there is no pulmonary vascular congestion . Emphysematous changes are again noted . A right lower lobe lesion posteriorly abutting the pleura appears unchanged compared to the recent chest CT . Ill - defined spiculated area within the left mid lung field appears unchanged compared to the prior chest radiograph , and does not appear to have a correlate on the CT . There is no pneumothorax or pleural effusion . Innumerable sclerotic metastases are better observed on the prior CT .
    OUTPUT:
    
No radiographic evidence for pneumonia . Persistent mediastinal lymphadenopathy and right lower lobe lesion compatible with malignancy .