Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal silhouette and hilar contours are unremarkable . Lungs remain hyperinflated with particularly pronounced right upper lobe bullae , but are of consolidation or findings of heart failure . Small left pleural effusion is new . There is no pneumothorax .
    OUTPUT:
    
1 . New small left pleural effusion . No heart failure . 2 . No focal consolidation to suggest pneumonia . 3 . Severe emphysema .