FINDINGS:
A longstanding left upper lobe oval nodule has been present since at
 least  and has not changed since at least  when a Chest CT report
 termed it benign.  Sclerosis at the right first costochondral junction as well
 as post-surgical changes from a wedge resection in the right upper lobe are
 all stable since .
 The cardiomediastinal silhouette and hila are normal.  There is no pleural
 effusion and no pneumothorax. Mild pulmonary vascular congestion is chronic or
 recurrent.

IMPRESSION:
No acute cardiothoracic process including no evidence of
 pneumonia.