Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac silhouette is mildly enlarged . The pulmonary vasculature is unremarkable . No pleural effusion or pneumothorax is identified . The aorta is tortuous . The right medial heart border and medial hemidiaphragm are slightly obscured . Possible opacity is seen on the lateral radiograph overlying the heart . In the appropriate clinical context , pneumonia is not excluded . There are moderate degenerative changes in the thoracic spine .
    OUTPUT:
    
1 . cardiomegaly . 2 . Right middle / lower lobe opacity , in the appropriate clinical context , may represent pneumonia .