Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest were acquired . The lungs are hyperexpanded , with marked enlargement of the retrosternal clear space . There is a lower lung predominant interstitial abnormality , best appreciated on the frontal projection , that is thought to represent an infectious process , less likely vascular congestion . There is no focal consolidation . The heart size is normal . The mediastinal contours are normal . A small - to - moderate right pleural effusion is unchanged compared to the prior study from ___ . A small left pleural effusion is new . There is no pneumothorax .
    OUTPUT:
    
1 . Bilateral lower lung reticular opacities , concerning for an infectious process , although an element of interstitial pulmonary edema can not be excluded . 2 . Unchanged small - to - moderate right and new small left pleural effusions . 3 . Findings consistent with chronic obstructive pulmonary disease .