Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a 4 .5 x 4 .5 cm rounded mass in the left upper lobe adjacent to the left hilus concerning for malignancy . Normal heart size . No pleural effusion or pneumothorax .
    OUTPUT:
    
4 .5 cm mass in the left upper lobe concerning for malignancy . Recommend further evaluation with chest CT .