Cough and elevated WBC, possible pneumonia. Opacities in the right lung on a background of emphysema and fibrosis have not resolved and are worse. Confluent opacities in the projection of the right upper lobe along the minor fissure as well as in the right middle lobe are new may represent infection or neoplasm.Unchanged cardiomediastinal silhouette.Degenerative changes of the spine.
Worsening opacities in the right lung which are now suspicious for neoplastic process, recommend thoracic CT. Dr. Elaine Worchester (4781) notified via Web exchange text page at 12:22 PM on 11/15/2016 in addition to an email. Superimposed indolent atypical infection such as MAI is also a possibility and is not excluded.