Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is chronic collapse of the right middle lobe . Findings are in the setting of flattened hemidiaphragms and generalized increased markings most consistent with COPD . This raises the concern for an extrinsic mass causing obstruction and subsequent volume loss . There is atelectasis at the left base but no no definite focal consolidation , pleural effusion , or pneumothorax . Cardiomediastinal silhouette is normal . Osseous structures are unremarkable .
    OUTPUT:
    
Chronic right middle lobe atelectasis in the setting of COPD is suspicious for malignancy . Recommend direct visualization with bronchoscopy . These findings were discussed with ___ by Dr . ___ at 1 :58 p .m .