Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size remains mildly enlarged . The aortic knob is calcified . Pulmonary vasculature is not engorged . Severe emphysema is re - demonstrated within the upper lobes . Patchy opacities are noted in the lung bases , more so in the right lower lobe . No large pleural effusion or pneumothorax is present . No pulmonary edema seen . There are no acute osseous abnormalities .
    OUTPUT:
    
Patchy opacities the lung bases , more so on the right lower lobe , which may reflect infection or aspiration . No large pleural effusion . Severe emphysema .