Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is background hyperinflation , consistent with background COPD . Cardiomediastinal silhouette is enlarged but unchanged . On lateral view , note is made of slightly tortuous tubular structure which may represent a densely calcified coronary artery . Of a densely calcified Coronary artery . Calcifications the paratracheal region are again noted . The right hemidiaphragm is slightly elevated . There is tenting of the right hemidiaphragm and obscuration of the right costophrenic angle seen on the AP view , but not confirmed on the lateral view . This could represent residual scarring and / or small amount loculated right lateral pleural fluid or thickening . Minimal linear scarring is also noted in the right mid lung . The configuration of the chest including the right lung , is keeping with findings on the chest x-ray from ___ , with interval improvement of previously seen right base atelectasis . There is upper zone redistribution , without overt CHF . Elsewhere , the lungs remain grossly clear . Note is made of severe kyphosis in the mid thoracic spine and a pectus carinatum configuration , with anterior wedge of multiple vertebral bodies , which appears similar to ___
    OUTPUT:
    
Tenting and scarring at the right lung base is similar to ___ . No obvious superimposed pneumonic infiltrate identified . A small amount of pleural fluid would be difficult to exclude . Upper zone redistribution , without overt CHF . Cardiomegaly and COPD , similar to prior . Right paratracheal calcifications again noted . Allowing for this , no right upper lobe lesion is identified . Trabecular pattern of the visualized vertebral bodies is compatible with renal osteodystrophy . There is suggestion of a rugger ___ bone density pattern in the vertebral bodies which can be seen with hyperparathyroidism .