FINDINGS:
The lungs are well inflated.  Patient has pectus excavatum deformity of the
 sternum.  Again seen is increased opacity abutting the right heart border on
 the frontal projection which is similar to the prior exam and likely reflects
 normal bronchovascular markings exaggerated in the setting of a pectus
 excavatum deformity.  However, in the correct clinical setting it is difficult
 to exclude a subtle pneumonia in this region.  Cardiac enlargement is again
 noted.  Mediastinal contour is normal.  Hilar congestion is noted.  No frank
 edema.  No large effusions or pneumothorax.  Bony structures are intact.

IMPRESSION:
1. Pectus excavatum deformity of the sternum likely simulates a right middle
 lobe pneumonia though clinical correlation is advised.
 2. Cardiomegaly with mild hilar congestion.