Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with architectural distortion of the lung parenchyma , suggestive of COPD . Compared to the prior examination , there is bronchial wall thickening in the left lower lobe with small peripheral nodular opacities at the left lateral lung base . The hilar and cardiomediastinal contours are normal . There is no pneumothorax . There is no pleural effusion . Pulmonary vascularity is normal .
    OUTPUT:
    
New bronchial wall thickening and small nodular opacities in the left lower lobe may represent bronchitis or early bronchopneumonia in the appropriate clinical setting .