Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Unchanged cardiomegaly . The aorta is calcified , indicating atherosclerosis . There are post radiation changes in the right hilum . Again seen is a large right upper lobe mass . Again seen is a small calcified granuloma in the right middle lobe . There is a background of emphysema . There is blunting of the right costophrenic angle , likely representing a small pleural effusion or pleural thickening . Again seen are multilevel degenerative changes of the visualized spine .
    OUTPUT:
    
No evidence of pneumothorax or rib fracture , as clinically questioned . Please note that chest radiographs are relatively insensitive for identifying rib fractures . No significant change in a large right upper lobe mass , consistent with patient 's history of non-small - cell lung carcinoma . Blunting of the right costophrenic angle , which may represent a small pleural effusion or pleural thickening