Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with prominent retrosternal clear space and coarsened interstitial markings suggesting emphysema . Evaluation for small nodules limited on radiograph . No large mass or consolidation . No large effusion or pneumothorax . The heart size is normal . There is an unfolded thoracic aorta . The hila appear slightly prominent . Bony structures appear intact . Chronic deformity of the left midshaft clavicle noted . No free air below the right hemidiaphragm .
    OUTPUT:
    
Severe emphysema . Given history provided , CT suggested to exclude underlying malignancy .