Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with flattening of the diaphragms and fibrotic changes compatible with COPD . Nodular right apical opacities are again seen , grossly unchanged . There is no definite acute cardiopulmonary process . The cardiomediastinal silhouette is within normal limits . No acute osseous abnormalities .
    OUTPUT:
    
Findings compatible with COPD with persistent nodular right apical opacities . No definite superimposed acute cardiopulmonary process .