Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded , with biapical hyperlucency , flattening of the hemidiaphragms , widening of the retrosternal clear space . Again seen is pleural scarring at the lung apices , left greater than right , with superior retraction of the left hilum . There has been interval enlargement of the branch pulmonary arteries . Heart size is normal . The aorta is tortuous and unfolded . No pleural effusions , pneumothorax , or pneumomediastinum . Left breast lumpectomy changes are noted .
    OUTPUT:
    
1 . COPD , with worsening pulmonary hypertension . 2 . Left upper lobe scarring .