Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and hilar contours are unremarkable . Pulmonary vascularity is normal . The lungs are hyperinflated with severe emphysema . Punctate calcified granulomas are seen within the lung bases . Linear opacities in the lung bases likely reflect scarring or subsegmental atelectasis . Residual patchy opacity within the left upper lobe likely reflects scarring , as seen on the prior chest CT . No new consolidation , pleural effusion or pneumothorax is identified . Scarring within the lung apices is again noted . There is diffuse demineralization of the osseous structures .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Severe emphysema . Residual left upper lobe opacity likely reflects scarring , as seen on the prior chest CT , with bibasilar linear opacities either reflecting subsegmental atelectasis or scarring .