Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The cardiomediastinal silhouette and hilar contour is stable . Calcifications are noted along the aortic arch . The lungs are hyperinflated with biapical attenuation of bronchovascular markings suggestive of emphysema / COPD . A rounded lucent focus is again seen in the lateral view and likely represents a small hiatal hernia . There is no effusion or pneumothorax . There is slight opacification of the posterior costophrenic recess which is stable since ___ . No acute bony abnormality is identified .
    OUTPUT:
    
1 . Findings suggestive of emphysema / COPD . Likely small hiatal hernia . 2 . Focal opacity projecting over the posterior costophrenic recess on the lateral view which is stable however given the history of chronic cough and COPD , nonemergent dedicated chest CT can be obtained for further evaluation .