Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear unchanged , again featuring enlarged central pulmonary arteries raising concern for pulmonary arterial hypertension that could be seen with intrinsic lung disease . Markedly irregular lung architecture with areas of multifocal scarring and hyperinflation suggest severe emphysema . There is no pleural effusion or pneumothorax . What is new is superimposed opacity in the right lower lobe suggesting pneumonia .
    OUTPUT:
    
New opacity in the right lower lobe suggesting pneumonia superimposed on severe background emphysema including areas of multifocal scarring and bullous change .