Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with flattening of the diaphragms suggestive of underlying COPD . The heart remains mild to moderately enlarged , and the aorta is unfolded . Mildly increased interstitial opacities are noted diffusely , likely related to chronic changes , and no overt pulmonary edema is present . There is no focal consolidation , pleural effusion or pneumothorax . There are multilevel degenerative changes noted in the thoracic spine .
    OUTPUT:
    
Chronic interstitial changes , without ___ pulmonary edema .