Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are clear without focal consolidation . There is moderate emphysema particularly at the upper lobes . The cardiomediastinal silhouette and hilar contours are within normal limits . There is no pleural effusion or pneumothorax . A right shoulder arthroplasty is unchanged .
    OUTPUT:
    
No acute cardiopulmonary process . Emphysematous changes .