Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right PICC terminates in mid SVC . Fiducial marker at the right upper lung is again noted adjacent to a cavitary right upper lobe lesion . Lungs are hyper inflated . There is no pneumothorax or large pleural effusion . Heterogeneous left retrocardiac opacification is new compared to ___ . Nodular opacity in superior segment of left lower lobe has been more fully characterized on prior CTA chest from ___ . Emphysema and scarring are again demonstrated Cardiomediastinal silhouette is normal size . Old healed fractures are noted in the left ribs .
    OUTPUT:
    
Left lower lobe opacity is concerning pneumonia or aspiration . Chronic severe pulmonary emphysema . Previously seen cavitary right apical lesion and superior segment left lower lobe nodular opacity have been more fully characterized on prior CTA .