Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe hyperexpansion is consistent with COPD . Biapical nodular pleural and parenchymal scarring is similar to the prior chest radiograph chest CT . There is no focal consolidation , pleural effusion , pulmonary edema , or pneumothorax . The cardiomediastinal silhouette is within normal limits . Airspace opacity with bronchiectasis in the right middle lobe is unchanged from multiple prior studies and likely related to prior right middle lobe pneumonia .
    OUTPUT:
    
1 . Severe hyperexpansion consistent with COPD . 2 . Biapical pleural and parenchymal scarring and right middle lobe bronchiectasis , similar to prior studies . 3 . No focal consolidation .