Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs remain hyperinflated , consistent with chronic obstructive pulmonary disease . Projecting over the anterior right third rib , there is a focal opacity that was not seen on the prior studies . While this may relate to the anterior rib , the pulmonary lesion is not excluded . Consider shallow oblique radiographs or nonurgent chest CT for further assessment . No focal consolidation or large pleural effusion is seen . There is no pneumothorax . The cardiac and mediastinal silhouettes are stable . There is persistent biapical pleural thickening .
    OUTPUT:
    
Hyperinflated lungs consistent with chronic obstructive pulmonary disease . Focal opacity projecting over the anterior right third rib that was not seen on the prior studies . While may relate to the anterior rib , a pulmonary lesion is not excluded .