Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single portable upright chest radiograph was obtained . Note of made of a rightward shift of the trachea , new since prior examination dated ___ that could a technical artifact due to low lung volumes and mildly lordotic positioning , but could also be the result of an increase in aortic caliber from aneurysm , pseudoaneurysm , or dissection . Allowing for differences in technique , the cardiomediastinal and hilar contours otherwise remain stable when compared to prior study dated ___ . Subpleural opacities predominantly within the right upper lobe are more conspicuous on prior examinations . Blunting of bilateral costophrenic angles may reflect bibasilar scarring or alternatively small pleural effusions . Aforementioned findings are suggestive of pulmonary fibrosis . Previously seen nodules on chest CT dated ___ not obvious on several prior radiographs and additionally not well appreciated on current examination . No focal opacity convincing for pneumonia is identified . Osseous structures demonstrate no acute abnormality .
    OUTPUT:
    
1 . Rightward deviation of the trachea , new since prior examination . CT with intravenous contrast recommended for further evaluation . 2 . Emphysema and pulmonary fibrosis . 3 . Previously seen lung nodule on prior CT study not well appreciated on current study and not obvious on several prior radiographs . Attention on follow up examinations advised .