Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated compatible with known emphysema . A small right - sided pleural effusion is new compared with prior exam . Streaky bibasilar opacities suggest bibasilar atelectasis versus scarring . A nodular opacity in the soft tissues of the lateral aspect of the right thoracic wall is better assessed in prior CT and represents a sclerotic lesion within the scapular tip . There is no pneumothorax . The upper sternotomy wire is fractured , but the remaining sternotomy wires are intact . Multiple surgical clips within the mediastinum correspond to prior surgery . The aorta is tortuous , with atherosclerotic calcifications of the aortic knob .
    OUTPUT:
    
Small right - sided pleural effusion . Bibasilar opacities may represent atelectasis versus scarring . No focal parenchymal opacities suggestive of pneumonia .