Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyper inflated , suggesting background COPD . There is moderate to moderately severe cardiomegaly . There are diffusely increased interstitial markings , of indeterminate acuity . The possibility of mild right hilar prominence can not be excluded . The left hilum is obscured by overlying structures . There is blunting of the costophrenic angles posteriorly , consistent with small bilateral effusions . There is a 9 .9 mm rounded nodular opacity in the right cardiophrenic region , not definitively identified on the lateral view . No pneumothorax is detected .
    OUTPUT:
    
1 . Probable background COPD . 2 . Moderate to moderately severe cardiomegaly . 3 . Diffusely increased interstitial markings . In the appropriate clinical setting , this could represent CHF and small bilateral effusions are noted . However , depending on the clinical presentation , the differential diagnosis includes other etiologies for increased interstitial markings , including atypical infection , inflammatory , and neoplastic processes . 4 . Possible prominence of the right hilum . Attention to this area after resolution of acute symptoms is requested . 5 . Nodular opacity in the right cardiophrenic region . The possibility of a pulmonary nodule can not be excluded . Again , attention to this area after resolution of acute symptoms is requested . Unless this proves to be a calcified granuloma or something on the patient 's skin , then further evaluation with chest CT would be recommended .