Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal silhouette is normal and unchanged . The hila and pleura are unremarkable . The lungs are markedly hyperinflated with flattening of the hemidiaphragms suggestive of chronic lung disease . Bibasilar atelectasis and scarring is seen and unchanged from previous studies . No focal opacifications , pleural effusions , or pneumothorax are seen . Chronic right - sided rib fractures are again seen and unchanged .
    OUTPUT:
    
No evidence of pneumonia . Severe emphysema .