FINDINGS:
The heart is normal in size.  There is a right-sided aortic arch. 
 The central pulmonary arteries are mildly prominent and the lungs are
 hyperinflated.  Attenuation and heterogeneity of upper lung architecture is
 concerning for emphysema.  A widespread opacity in the right upper lobe
 suggests pneumonia.  There is also a patchy opacity in the posterior right
 lower lobe, also worrisome for pneumonia, with a small pleural effusion on the
 right only.  The left lung appears clear.  There is no pneumothorax.  The
 osseous structures are unremarkable.

IMPRESSION:
Evidence for widespread pneumonia in the right lung in the
 setting of suspected emphysema involving the upper lobes.  Suspected
 emphysema.  Right-sided aortic arch.