Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated compatible with COPD . Heart size is normal . Enlargement of the hila bilaterally likely reflects pulmonary arterial hypertension . There is no pulmonary vascular engorgement . Mediastinal contours are unremarkable . Bullous changes with scarring is seen within the lung apices . Linear opacities within the right mid lung field and left lung base also may reflect chronic changes . Calcified granuloma in the right middle lobe is present . No focal consolidation , pleural effusion or pneumothorax is seen . There is diffuse demineralization the osseous structures .
    OUTPUT:
    
COPD . Chronic changes within the lung apices , right mid lung field and left lung base . No focal consolidation concerning for pneumonia . Likely pulmonary arterial hypertension .