Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal and hilar contours are within normal limits . Lungs are hyperinflated . There is paucity of pulmonary markings at the upper lobes , suggestive of underlying emphysema . Note is made of reticular opacities in both lower lobes . There is no focal consolidation , pleural effusion or pneumothorax . Moderate hiatal hernia .
    OUTPUT:
    
Emphysematous changes noted at the upper lobes with reticular basilar opacities . Findings could reflect atypical distribution of emphysema versus atypical pneumonia or scarring . Short term follow up radiographs may be helpful .