Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with study of ___ , there is again hyperexpansion of the lungs with flattening of the hemidiaphragms consistent with severe emphysema . Suture material in the left lung is again consistent with prior resection . No evidence of acute focal pneumonia , vascular congestion , or pleural effusion .
    OUTPUT:
    
Emphysema without acute pneumonia .