IMPRESSION:
PA and lateral chest compared to :
 
 Most striking abnormality seen on the frontal view is a region of indistinctly
 marginated opacity in the right lower lung, triangulating to the middle lobe
 on the lateral view.  Lateral view also shows a new sharply marginated region
 of opacity obscuring the left hemidiaphragm over the stomach.  Finally, there
 is a new region of irregular opacities in the right apex projecting over the
 second anterior rib which could be a cavity, alongside a region of mild
 pleural thickening.  The constellation of findings is not simply explained by
 a single diagnosis but is worrisome for a variety of conditions including
 multifocal pneumonia, pulmonary infarctions and tuberculosis, in the right
 apex.  Dr.   I discussed these findings by telelphone, and agreed the
 patient should have a CTA.
 
 There is no layering pleural effusion.  Heart size is top normal, exaggerated
 by a pectus deformity.  There is no good evidence for central lymph node
 enlargement.