Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large left hiatal hernia occupying the left lower hemi thorax . Where seen , the lungs are clear without focal consolidation . There is no right - sided pleural effusion . Cardiomediastinal silhouette is unchanged . Chronic degenerative changes noted at the shoulders bilaterally .
    OUTPUT:
    
Large hiatal hernia occupying a significant portion of the left hemithorax . No definite superimposed acute cardiopulmonary process .