FINDINGS:
PA and lateral views of the chest were obtained. The mediastinal
 contour is somewhat prominent, which likely in part reflect patient's slight
 leftward rotation as no mediastinal mass was seen on prior CT. The lungs are
 hyperinflated compatible with COPD.  A calcified granuloma is again noted in
 the left mid lung.  Calcified lymph nodes in the left hilum are better
 assessed on the prior CT.  Heart size is top normal.  No definite evidence of
 pneumonia or CHF.  No pleural effusion or pneumothorax.  The imaged osseous
 structures appear intact.

IMPRESSION:
Hyperinflated lungs without evidence of pneumonia or CHF.  Slight
 mediastinal prominence likely reflects patient's slight leftward rotation.