Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are again low and absence of lateral limits assessment . Bilateral upper lung opacities are seen and more pronounced than on the previous examination . On the prior study , they were suggested to be pleural - based based on their appearance on the lateral , although this assessment is not possible today . Given that opacities have increased over time suspicion is high for possible malignancy . Additionally , subtle infectious process would be difficult to exclude in these areas . Calcified granuloma in the right lower lung is again demonstrated . The heart size remains top normal with calcified aortic knob . Degenerative changes are noted at the right AC and glenohumeral joints .
    OUTPUT:
    
Increase in size of left greater than right upper lung , possibly pleural - based based on the prior examination , opacities for which further evaluation by CT is recommended . Malignancy is of concern . This was discussed with Dr . ___ by Dr . ___ at 12 :50 PM on ___ .