Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . This chest radiograph study confirms the previous radiographic finding of a subtle right para-mediastinal opacity . This opacity appears larger than the last available chest radiograph from ___ . Upon review of the CTA exam from ___ , this opacity is likely reflecting normal vascular structure but this assumption should be confirmed by a repeat chest CT . Heart is moderately enlarged . Tortuous descending aorta is seen . There may be a small left pleural effusion .
    OUTPUT:
    
Right paramediastinal opacity , likely normal vascular structure . Confirmation with chest CT is recommended .