Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , consistent with chronic obstructive pulmonary disease . There is streaky atelectasis seen at the left lung base . Otherwise , there is no focal consolidation concerning for pneumonia . There is no pleural effusion or pneumothorax . The pulmonary nodules seen on the CT abdomen and pelvis from ___ are too small to be seen on this study . There is a moderate size hiatal hernia . The cardiac and mediastinal contours are unchanged . A questionable subtle opacity is noted but appears unchanged from at least ___ .
    OUTPUT:
    
1 . Changes from chronic lung disease without an acute cardiopulmonary process . 2 . Questionable opacity seen in the right lung apex , best appreciated on the lateral view , is unchanged from at least ___ . If needed , further evaluation can be performed with an apical lordotic view . These findings were discussed with Dr . ___ by Dr . ___ at ___ on ___ by telephone at the time of interpretation .