Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . Since the prior study , there has been interval development of a large rounded posterior left upper lobe mass , measuring in the order of at least 9 .1 x 7 .0 cm rounded opacity highly concerning for underlying pulmonary malignancy . There is left paratracheal soft tissue thickening / opacity with rightward deviation / mass effect upon the trachea . Right infrahilar opacity noted on the prior study is stable . The lungs remain hyperinflated consistent with chronic obstructive pulmonary disease . In addition to the large left upper lobe opacity , there are areas of multiple reticulonodular opacity in the left mid - to - lower lung which may represent vascular structures ; however , further extent of malignancy or infection is not excluded . Left apical opacity above the rounded opacity may be related to malignancy with possible small pleural effusion . No pneumothorax is seen . The cardiac silhouette is not enlarged . There may be a very small nodular opacity projecting over the posterior right sixth rib , which can also be further evaluated on chest CT .
    OUTPUT:
    
Interval development of large posterior left upper lobe rounded opacity with left paratracheal thickening and with mass effect and rightward deviation of the trachea , highly worrisome for malignancy . Findings were discussed with Dr . ___ at 9 :05 p .m . on ___ . Additional subtle reticular nodular opacities projecting over the left mid - to - lower lung may relate to vascular structures , although underlying disease spread or infection are not excluded . COPD . Possible small left apical pleural effusion .