Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with emphysematous changes again demonstrated . Heart size is normal . The mediastinal and hilar contours are unchanged , with prominence of the right hilum . Mild pulmonary vascular congestion is noted with cephalization of vascular markings . No focal consolidation or pleural effusion is seen . Biapical pleural parenchymal scarring is present without evidence for pneumothorax . There are no acute osseous abnormalities .
    OUTPUT:
    
Emphysema and mild pulmonary vascular congestion .