Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The hilar and mediastinal contours are normal . A tracheostomy tube is seen in place . There is a well - circumscribed rounded opacity along the medial left lung base which appears more prominent , compared to the prior exam . There is no evidence of a pneumothorax . The bones are diffusely osteopenic , which are otherwise unremarkable .
    OUTPUT:
    
Rounded opacity at the left lung base appears more prominent compared to the prior exam . This raises concern for diaphragmatic herniation or possibly rupture . Further imaging evaluation with CT may be helpful . No evidence of pneumonia .