Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded and clear . The cardiac silhouette is normal . A right upper lobe nodule is noted unchanged . Opacity in the right paramediastinal lung is also unchanged . No pleural effusion or pneumothorax is present . Sternal wires are intact . Aortic valve replacement is noted in appropriate position .
    OUTPUT:
    
Unchanged right upper lobe nodule and right paramediastinal opacity . No pneumothorax .