Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the remote examination , there has been interval development of bilateral lower lobe , and right middle lobe opacification . There are hyperinflated lungs with irregularity of the peripheral vasculature in keeping with emphysema . There are no pleural effusions or pneumothorax . The cardiomediastinal and hilar contours are normal . Pulmonary vascularity is normal . There are multilevel degenerative changes of thoracolumbar spine as manifested by marginal osteophytic formation , loss of intervertebral disc height and endplate sclerosis .
    OUTPUT:
    
Bibasilar and right middle lobe opacification , most compatible with multifocal pneumonia though a post-obstructive process is of concern . Recommend followup to resolution or alternatively Chest CT is recommended .