Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with bullous emphysematous disease , again most pronounced in the lung apices . The heart size is normal . The mediastinal and hilar contours are unremarkable . No focal consolidation , pleural effusion or pneumothorax is present . Prominent interstitial markings within the lung bases are similar compared to the prior study , and may reflect a chronic interstitial lung disease . There are mild degenerative changes of the thoracic spine .
    OUTPUT:
    
No acute cardiopulmonary abnormality . Severe bullous emphysema .