Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear unchanged . There is no pleural effusion or pneumothorax . The lungs appear hyperinflated . Irregular pulmonary architecture is suggestive of emphysema . Scarring at each lung apex is again widespread . Although mostly similar , there is a newly apparent nodular focus at the right apex whose better defined portion measures about 7 mm in diameter with surrounding vague patchy opacity which has also increased . Otherwise , chest findings appear stable . Moderate rightward convex curvature is centered along the mid - to - upper thoracic spine . Mild degenerative changes are noted along the thoracic spine .
    OUTPUT:
    
1 . Increased nodular density at the right lung apex in the setting of suspected emphysema . A true pulmonary nodule should be considered as a possible etiology and chest CT performed when clinically appropriate . 2 . No definite evidence of acute disease . Findings entered into the ED dashboard while the patient was still in the ER .