Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is at the upper limits of normal size . The aortic arch is calcified . A small oval nodular focus projects along the superior aspect of the left hilum . The lungs are hyperinflated . There are trace bilateral pleural effusions . Nipple shadows are visualized bilaterally . The lungs appear clear . The bones appear demineralized .
    OUTPUT:
    
1 . Findings suggesting emphysema including hyperinflation and coarse lung markings . 2 . Trace bilateral pleural effusions . 3 . Small left suprahilar nodular focus , probably a normal vascular shadow but a pulmonary nodule is also possible . If available , correlation to prior films is recommended ; if not available to show long - term stability , then chest CT is recommended when clinically appropriate to evaluate further .