Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison to the most recent prior study of ___ , there is increased opacity at the left lung base , which in the setting of a productive cough and fever raises concern for pneumonia . However , a remote prior chest CT from ___ demonstrates bibasilar fibrotic changes and the increased markings in the left lung base may also represent progression of the patient 's chronic lung disease / emphysema . Right apical pleural thickening is also seen , which is similar to the prior chest radiograph and chest CT . The lung volumes remain decreased . Irregularity of the peripheral pulmonary vasculature is compatible with emphysema . The cardiomediastinal silhouette is mildly enlarged but stable . The mediastinal and hilar contours are within normal limits . The pulmonary vasculature is not engorged , and there is no evidence of overt pulmonary edema .
    OUTPUT:
    
Progression of chronic lung disease / emphysema with increased opacity at the left lung base which given symptoms of fever and cough raises concern for a superimposed pneumonia . Findings were discussed by Dr . ___ with Dr . ___ ___ telephone at 5 p .m . on ___ .