Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Low lung volumes cause bronchovascular crowding . A dual - chamber left pectoral pacemaker and its leads project in expected location . There is no focal consolidation pleural effusion , pulmonary edema , or pneumothorax . The cardiomediastinal silhouette is normal . The aortic arch is heavily calcified . Relatively dense nodules in bilateral upper lobes likely represent granulomas or pleural and parenchymal scarring . Surgical clips are noted in the right upper quadrant .
    OUTPUT:
    
Low lung volumes . No evidence of acute cardiopulmonary process .