Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . Mediastinal and hilar contours are unchanged , and the pulmonary vasculature is not engorged . Moderate to severe emphysema is again demonstrated within upper lobe predominance . Calcified left hilar lymph nodes and scattered calcified granulomas are again present compatible with prior granulomatous disease . No focal consolidation , pleural effusion or pneumothorax is present . There are no acute osseous abnormalities . Amorphous calcification projecting over the left medial upper hemithorax is unchanged .
    OUTPUT:
    
Emphysema . No acute cardiopulmonary process .