Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded , in keeping with COPD . Evaluation of the cardiac silhouette and left lung base is limited due to the presence of a large hiatal hernia , unchanged from prior studies , with adjacent atelectasis . Allowing for this , the heart size likely remains mildly enlarged . The mediastinal and hilar contours are within normal limits . There is no overt pulmonary edema . No significant pleural effusion , focal consolidation or pneumothorax is appreciated . A subtle opacity projects just superior to the right clavicle and seen on the prior study of ___ .
    OUTPUT:
    
1 . No focal consolidation concerning for pneumonia . No evidence of fluid overload . 2 . Large hiatal hernia . 3 . Subtle opacity projecting superior to the right clavicle . Recommend an AP lordotic view as initial followup and , if the finding persists , CT could be considered for further evaluation at that time .