Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The costophrenic angles are not fully included on the frontal image . Given this , there is small to moderate right pleural effusion . A trace left pleural effusion is difficult to exclude . The lungs are hyperinflated , consistent with chronic obstructive pulmonary disease . Relative lucency at the lung apices may be due to underlying pulmonary emphysema . There is bibasilar atelectasis . The cardiac silhouette is mildly enlarged . The aorta is calcified and tortuous .
    OUTPUT:
    
Costophrenic angles not fully included on the frontal view . Given this , small - to - moderate right pleural effusion with overlying atelectasis , underlying consolidation can not be excluded . Trace left pleural effusion difficult to exclude . Mild cardiomegaly . COPD and likely pulmonary emphysema .