Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate to large pneumothorax on the right . No signs of tension . Coarsened lung markings and flattened diaphragms suggests underlying emphysema . Cardiomediastinal silhouette appears within normal limits . There is no free air below the diaphragm .
    OUTPUT:
    
Moderate to large right pneumothorax . Likely underlying COPD .