Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest demonstrate moderate enlargement of the cardiac silhouette . The trachea is deviated to the right with prominent soft tissue in the upper mediastinum . There is an enlarged aortic knob and unfolding of the aorta . There is persistent elevation of the left hemidiaphragm . The lungs are clear . No pleural effusion or pneumothorax .
    OUTPUT:
    
No pneumonia . Trachea is deviated to the right with prominent soft tissue in the upper mediastinum possibly related to position but a substernal goiter is possible . Recommend comparison with prior chest radiographs if available , and if not follow up PA and lateral chest x-ray in ___ months . An email was sent to the ED QA nurses regarding the recommendation for follow up .