Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with emphysematous changes again noted , most pronounced in the lung apices . Cardiac , mediastinal and hilar contours are unchanged without evidence for pulmonary edema . Known esophageal malignancy is better assessed on the prior CT . Streaky opacities in the lung bases may reflect aspiration , atelectasis or infection . No pleural effusion or pneumothorax is seen . No acute osseous abnormalities identified .
    OUTPUT:
    
Bibasilar patchy opacities could reflect aspiration , atelectasis or infection . Severe emphysema . Known esophageal malignancy better assessed on prior CT .