Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding PA and lateral chest examination of ___ . The heart size remains unchanged and is within normal limits . Mild widening and elongation of the thoracic aorta is unaltered . No mediastinal masses are seen . Bilaterally , the lungs demonstrate a rather irregular pulmonary vascular distribution coinciding with multiple areas of increased translucency most marked in the lung bases where they coincide with low positioned and flattened diaphragms . These findings are again indicative of rather advanced COPD / emphysema . Comparison with the previous examination demonstrates increased local markings on the left lung base can be identified on comparison of the lateral views to involve mostly the anterior basal regions , thus representing infiltrates in the periphery of the upper lobe lingula . No new pleural effusion can be identified as the lateral and posterior pleural sinuses are free and there is no evidence of pneumothorax in the apical area .
    OUTPUT:
    
No evidence of cardiac enlargement or pulmonary vascular congestion . General pulmonary findings consistent with advanced COPD as before . A new hazy density in lingula area indicative of exacerbation in this area . Followup examination after successful treatment is recommended in ___ weeks .