Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Elevation of the left hemidiaphragm is unchanged compared to the prior examination . Lungs are markedly hyperinflated suggestive of underlying emphysema . Relative lucency at the right base corresponds to bullous changes on a CT dated ___ . Since the prior study , there is coarsening of the interstitium with associated parenchymal distortion and scarring , particularly in the upper lungs . There are scattered nodular opacities , some of which are stable , but some of which have developed , especially a 1 cm irregular opacity at the left apex . Further imaging evaluation with chest CT is recommended at this time . There is no focal consolidation , pleural effusion , or pneumothorax . Cardiomediastinal silhouette is stable . Healed left sided rib fractures are noted .
    OUTPUT:
    
Increased upper lobe predominant interstitial abnormality and bilateral nodular opacities . Further imaging evaluation with dedicated chest CT is recommended at this time .