Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Flattening of the hemidiaphragms and increased AP diameter of the thorax is consistent with chronic obstructive pulmonary disease . No consolidation or pulmonary edema is identified . There is no pleural effusion . Cardiomediastinal and hilar contours are within normal limits .
    OUTPUT:
    
Chronic , severe emphysema . No pneumonia or heart failure .