Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead pacemaker is again noted , with lead tips over the right atrium and right ventricle . There is hyperinflation , consistent with background COPD . There is mild cardiomegaly , unchanged . There is upper zone redistribution , but no overt CHF . Minimal atelectasis at the left lung base . No frank consolidation . Possibility of tiny left and right effusions can not be excluded . A rounded ___ .2 mm calcification is noted overlying the superior mediastinum slightly to the right of midline -- ___ CT shows this to represent a calcified nodule in the inferior right thyroid lobe . Incidental note is made of coarse calcifications in the right breast
    OUTPUT:
    
1 . COPD and mild cardiomegaly . 2 . Upper zone redistribution and probable trace bilateral effusions , without other evidence of CHF . 3 . Minimal atelectasis at the left base . No focal infiltrate or consolidation to suggest pneumonia . If clinical suspicion for pneumonic infiltrate remains high , then further assessment with repeat radiograph including lateral view could help to assess for developing pneumonic infiltrate . 4 . Small calcified thyroid nodule again noted .