Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again , the lungs are hyperinflated , with attenuated vascular markings particularly towards the apices , compatible with moderate to severe emphysema . There is no consolidation , pulmonary edema , pleural effusion , or pneumothorax . Mild bibasilar atelectasis is present . The cardiomediastinal silhouette is normal . A large hiatal hernia with an air - fluid level is unchanged .
    OUTPUT:
    
1 . No acute cardiopulmonary process . 2 . Emphysema . Large hiatal hernia . 3 . Stable large hiatal hernia .