Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP portable upright chest radiograph was provided . The lungs are hyperinflated with upper lobe lucency compatible with emphysema . No focal consolidation , effusion , or pneumothorax seen . Cardiomediastinal silhouette is normal . Bony structures are intact .
    OUTPUT:
    
Severe emphysema without superimposed consolidation .