Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are mildly hyperinflated . The previously seen subtle density projecting over the right upper lung is unchanged . A small opacity that projects over the right lower lung is new . There is no pleural effusion , pneumothorax , or pulmonary edema . A left pectoral dual - chamber pacemaker and its leads project in unchanged location .
    OUTPUT:
    
New focal right middle lobe opacity and unchanged right upper lung opacity . Given these equivocal findings for an infectious process with a right lower lobe nodule seen on CT , chest CT is recommended for further evaluation .