Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with severe emphysematous changes . There is scarring more pronounced at the right apex . There is bibasilar atelectasis . A 2 cm rounded opacity in the right lower lung appears new since prior study . No large consolidation is identified . The cardiac silhouette is within normal limits . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
1 . Hyperinflated lungs with emphysema . No focal consolidation . 2 . 2 cm rounded opacity in the right lower lung , new since prior study . Although this could represent nipple shadow , in the absence of recent cross - sectional imaging and underlying parenchymal abnormalities , a CT chest is recommended for further evaluation .