Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again , the overall chest anatomy is distorted by severe levoconvex thoracic scoliosis . Redemonstrated is a left hilar spiculated opacity with evidence of retraction of the adjacent parenchyma and left lung volume loss , demonstrating slight interval progression compared to the prior exam from ___ . There is a consolidation along the right middle lobe as well as a generalized opacity overlying the left mid-to - lower lung . There may be small bilateral pleural effusions . The cardiomediastinal silhouette is mildly shifted leftward . There is no evidence of a pneumothorax . The visualized osseous structures are unremarkable .
    OUTPUT:
    
1 . New opacity along the right middle lobe as well as a generalized opacity overlying the mid - to - lower left lung raises concern for an infectious process . 2 . Spiculated left hilar opacity with retraction of the adjacent parenchyma is again concerning for a malignant process or represent post - treatment scarring ; however , comparison with outside prior cross sectional studies or a new chest CT is recommended for further evaluation .