Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with flattening of the bilateral hemidiaphragms , compatible with COPD . There is opacification of the right perihilar region and right lung base medially , obscuring the right heart border , which raises the possibility of right middle lobe pneumonia . There is slight blunting of the right costophrenic angle , which may represent a small right pleural effusion . The left lung is relatively clear . No pneumothorax is present . The pulmonary vasculature is slightly indistinct . There is no overt pulmonary edema . The cardiac silhouette is top normal in size . The mediastinal contours are within normal limits with a tortuous thoracic aorta and minimal calcification of the aortic knob .
    OUTPUT:
    
Possible right middle lobe opacity in the setting of background COPD . PA and lateral radiographs would be helpful for further evaluation .