FINDINGS:
Heart is upper limits of normal in size, and mediastinal and hilar
 contours are normal.  A subtle area of opacity previously reported in the
 periphery of the right upper lobe at the level of the sixth posterior right
 rib level is difficult to compare to previous exam due to scapular overlay but
 appears slightly more prominent.  Lungs are hyperexpanded and otherwise clear.
 There are no pleural effusions or acute skeletal findings.

IMPRESSION:
Focal peripheral right upper lobe noduular opacity appears slightly more
 prominent than on prior studies, possibly due to overlap of the right scapula.
 However, further evaluation with a chest CT may be helpful to more fully
 characterize this region and to exclude the possibility of a slowly growing
 lung adenocarcinoma at this site.  
 
 Findings and recommendation were discussed by telephone with Dr.  at 11
 a.m. on  at the time of discovery.