Severe pulmonary fibrosis. Pulmonary hypertension.
New 34 mm diameter subpleural mass, posterior segment right upper lobe, abutting the major fissure posteriorly.
No pleural effusion.
13 mm right lower paratracheal node, increased in size.
No adrenal or bony lesion.
Conclusion: New right upper lobe mass is suspicious for primary lung carcinoma. CT or ultrasound-guided biopsy is possible if required clinically.