Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . Mediastinal contours are unchanged . There is crowding of the bronchovascular structures due to low lung volumes . Left hilum appears somewhat enlarged compared to prior study , but again this may be due to low lung volumes . There is no pulmonary vascular engorgement . Pleural thickening and scarring within the right lung base is unchanged as is a linear opacity within the superior segment of the right lower lobe compatible scarring . Minimal left retrocardiac opacity likely reflects atelectasis . No left - sided pleural effusion is seen , and there is no pneumothorax . Multilevel severe degenerative changes of the thoracic spine are present . Clip is seen within the right anterior chest wall .
    OUTPUT:
    
1 . Low lung volumes . This causes enlargement of the left hilum , as well as bronchovascular crowding and mild left basilar atelectasis . Repeat PA and lateral views with improved inspiratory effort is recommended to better assess the left hilum and left lung base . 2 . Chronic pleural thickening and scarring within the right lung base .