Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart is normal size and cardiomediastinal silhouette is within normal limits . Extensive atherosclerotic calcifications are present in the aortic arch and along the descending thoracic aorta . Symmetrically expanded lungs are hyperinflated suggestive of underlying emphysema . Upper lobe opacities with volume loss and parenchymal distortion could represent post inflammatory changes or an acute infectious process including TB . Clinical correlation is advised . No pleural effusion , or pneumothorax .
    OUTPUT:
    
Bilateral upper lobe opacities with volume loss and parenchymal distortion . Comparison to remote studies would be helpful to assess for chronicity . Acute infection including TB should also be considered .