Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are fully expanded and clear without focal consolidations . There is a single , approximately 4 mm nodular opacity projecting over the posterior lungs only appreciated on lateral view . Heart size is normal and cardiomediastinal silhouettes are unremarkable . No pleural effusions or pneumothorax .
    OUTPUT:
    
No radiographic evidence of pneumonia or other acute cardiopulmonary abnormalities . Small nodular opacity described above is likely a spinous process tip in this projection , but can not rule out a pulmonary nodule . Recommend oblique radiographs for further evaluation .