Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is hyperinflation suggestive of COPD . The cardiomediastinal silhouette is enlarged , but unchanged . The aortic knob appears high - riding , at the upper limits of normal in diameter , but unchanged . Pulmonary hila are prominent with a tapered appearance which could reflect presence pulmonary hypertension , though they are also somewhat irregular in contour . There is upper zone redistribution and mild prominence of interstitial markings , with peribronchial cuffing and with ___ B - lines noted at the lower left chest wall . Atelectasis and thickening of the bronchovascular markings in the right cardiophrenic region is again noted , though less pronounced . This could represent a site of resolving aspiration , infection , or atelectasis . Again seen is patchy retrocardiac opacity , consistent with left lower lobe collapse and / or consolidation . No gross effusion . Focal density in the left anterior rib likely represents side of an old healed fracture or artifact due to overlapping rib shadows . Medial portion of both lung apices is obscured by the the patient 's chin . Again seen is mild loss of height of ___ mid thoracic vertebral bodies , question T7 and T8 .
    OUTPUT:
    
1 . Cardiomegaly and background COPD . Possible pulmonary hypertension . 2 . Left lower lobe collapse and / or consolidation , relatively similar to the prior study . 3 . Resolving changes in the right cardiophrenic region consistent with resolving atelectasis , infection and / or site of aspiration . 4 . Upper zone redistribution with evidence for interstitial thickening , question chronic versus interstitial edema .