Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal . Mediastinal and hilar contours are unchanged . Lungs hyperinflated . Emphysematous changes again noted , most pronounced in the upper lobes . No focal consolidation , pleural effusion or pneumothorax is detected . No acute osseous abnormalities seen . Multilevel moderate degenerative changes are noted in the thoracic spine . Multiple clips are noted in the left axilla and there is evidence of prior left mastectomy .
    OUTPUT:
    
Emphysema . No acute cardiopulmonary abnormality otherwise noted .