Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . The aorta is tortuous . Hilar contours are normal . Right apical opacity measuring 4 .8 x 6 .5 cm is concerning for a primary lung malignancy . No clear osseous destruction is visualized . Subsegmental atelectasis is noted in the lung bases . No pleural effusion or pneumothorax is present . Moderate degenerative changes are seen in the thoracic spine .
    OUTPUT:
    
4 .8 x 6 .5 cm right apical opacity concerning for a primary lung malignancy . Further assessment with contrast - enhanced chest CT is recommended .