FINDINGS:
The cardiomediastinal and hilar contours are within normal limits.  There is
 tortuosity of the descending aorta. Hyperinflated lungs and increased
 pulmonary markings likely relate to chronic lung disease. There is a focal
 area of increased opacity in the right upper lung which is concerning for
 pneumonia.  No large pleural effusion or pneumothorax is identified. Ossesous
 structures appear subtlely dense, most compatible with metastatic disease.

IMPRESSION:
Increased opacity in the right upper lung concerning for
 pneumonia. Interval follow up is recommended after treatment to document
 resolution.