Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are relatively hyperinflated , which can be seen with COPD . No focal consolidation is seen . . No pleural effusion or pneumothorax is seen . The cardiac silhouette is not enlarged . Slight prominence of the hila bilaterally may be due to central pulmonary vascular engorgement although underlying lymphadenopathy is not entirely excluded . Multi - level degenerative changes along the spine .
    OUTPUT:
    
Slight prominence of the hila bilaterally may be due to central pulmonary vascular engorgement although underlying lymphadenopathy is not excluded . If this is of clinical concern , follow - up chest CT would provide further evaluation . Hyperinflated lungs without focal consolidation .