Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and hilar contours are similar with mild enlargement of the pulmonary arteries suggestive of pulmonary arterial hypertension . Lungs remain hyperinflated with bullous emphysematous changes most pronounced at the lung bases compatible with panlobular emphysema . Pulmonary vasculature is not engorged . No focal consolidation , pleural effusion or pneumothorax is present . There are no acute osseous abnormalities . Multiple spiral tacks are seen along the left diaphragm contour with chronic elevation of the left hemidiaphragm compatible with previous diaphragmatic hernia repair . Multiple old left - sided rib fractures are also noted .
    OUTPUT:
    
Panlobular emphysema and evidence of pulmonary arterial hypertension . No focal consolidation to suggest pneumonia .