Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . Lungs appear clear and hyperinflated . Flattened diaphragms and widened AP diameter of the chest suggests underlying emphysema . No pleural effusion or pneumothorax . Cardiomediastinal silhouette is normal . Bony structures appear intact .
    OUTPUT:
    
COPD , no superimposed pneumonia or CHF .