Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to exam on ___ at 14 : 14 , there is no significant change . Lungs are hyperinflated because of extremely severe emphysema , particularly large biapical bullae . Small right pneumothorax , if any , has not changed , though the assessment is unreliable in setting of bullous emphysema . Blunting of the right costophrenic sulcus and basal opacity likely reflect pleural effusion and atelectasis . The left lung appears unchanged from prior with scarring and atelectasis at the apex . Heart size is within normal limits . Mediastinal and hilar contours are unremarkable . There is no evidence for pulmonary edema or pulmonary consolidation . Pigtail catheter is in place , unchanged in position . Valves are seen at the right hilum , unchanged in position .
    OUTPUT:
    
1 . Unchanged appearance of bilateral emphysematous lungs . Possible small right pneumothorax , unchanged . 2 . Small right pleural effusion and atelectasis , unchanged .