Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Emphysematous changes are re- demonstrated with hyperinflation of the lungs . Heart size remains mildly enlarged . The mediastinal contour is similar with previously demonstrated mediastinal lymphadenopathy better seen on CT . Hilar contours are unchanged , and there is no pulmonary vascular congestion . Small right pleural effusion appears unchanged compared to the most recent chest radiograph , and there is no pneumothorax . Streaky opacities in the right lung base likely reflect areas of atelectasis . Interstitial opacities in the left lung base appear chronic . Spiculated nodular opacity in the periphery of the left upper lobe appears relatively unchanged . There are no acute osseous abnormalities .
    OUTPUT:
    
Small right pleural effusion , not substantially changed from the previous chest radiograph . Streaky right basilar opacities likely reflect areas of atelectasis , without focal consolidation . Unchanged spiculated nodular opacity in the periphery of the left upper lobe .