Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size remains normal in size . The aorta is tortuous . Pulmonary vasculature is not engorged . Lungs remain hyperinflated with scarring noted at the lung apices . 11 mm spiculated nodular opacity within the left upper lobe appears grossly unchanged compared to the previous chest radiograph . No focal consolidation , pleural effusion or pneumothorax is present . No acute osseous abnormality is seen .
    OUTPUT:
    
No acute cardiopulmonary abnormality . 11 mm spiculated nodular opacity in the left upper lobe is grossly unchanged , but should be better evaluated with CT of the chest for direct comparison with prior CT chest .