FINDINGS:
The heart is normal in size.  There is new lobular thickening of
 the right upper mediastinum and also a nodular appearance to the right hilum. 
 Widespread opacity is present in the right middle lobe.  Elsewhere, the lungs
 appear clear.  There is no pleural effusion or pneumothorax.  Minimal
 degenerative changes are noted along the mid thoracic spine.

IMPRESSION:
Widespread right middle lobe opacity worrisome for pneumonia, but a
 post-obstructive pneumonitis should be considered, noting abnormal contours of
 the right upper mediastinum and right hilum.  Evaluation with chest CT,
 preferably with intravenous contrast, is recommended to evaluate further to
 consider the possibly of coinciding malignancy.