Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . The aorta appears mildly tortuous . Remainder the mediastinal contour is on remarkable . The hila appear prominent bilaterally , which suggests enlargement of the pulmonary arteries . Lungs are hyperinflated with marked emphysematous changes seen in the upper lobes . Linear and patchy opacities within the lung bases may reflect areas of atelectasis with scarring . No focal consolidation , pleural effusion or pneumothorax is detected . Multilevel degenerative changes are noted in the imaged thoracic spine .
    OUTPUT:
    
Emphysema with bibasilar linear and patchy airspace opacities , likely atelectasis or scarring , although infection can not be excluded in the correct clinical setting . Enlargement of the pulmonary arteries bilaterally may suggest underlying pulmonary arterial hypertension .