Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is top normal . Cardiomediastinal silhouette and hilar contours are unremarkable . Lungs are clear . A punctate sclerotic focus projecting over the intersection of the left fifth posterior and third anterior rib is unchanged from prior study and likely represents a calcified bone island or granuloma . Lungs are otherwise clear . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
No acute intrathoracic process .