Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . Midline sternotomy wires and mediastinal clips are again noted . There is a calcified nodule in the left upper lobe again noted compatible with a calcified granuloma . The lungs are hyperinflated with widened AP diameter and flattened diaphragms suggestive of underlying COPD . There is no focal consolidation , or pneumothorax . The cardiomediastinal silhouette appears normal . The imaged osseous structures are intact .
    OUTPUT:
    
COPD , no superimposed pneumonia .