Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding similar study of ___ . The heart size is at the upper limit of normal variation with a mild prominence of the left ventricular contour to the left , but absence of significant left atrial enlargement . Thoracic aorta is moderately widened and elongated and shows some calcium deposits in the wall at the level of the arch . No new local contour abnormality is present . The pulmonary vasculature is not congested . Pulmonary vasculature shows some regional distortion with some areas of increased translucencies in the left lung mid field . This slightly abnormal distribution of the vasculature was not present at least to the same extent on the previous study . On the other hand , a left lower lobe basal linear density in supradiaphragmatic position existed already at that time . In the right hemithorax , similar somewhat irregular vascular distributions are noted , but are less prominent . As they occur in conjunction with relatively low positioned and somewhat flattened diaphragms is suggestive of COPD . There is no evidence of any acute parenchymal pulmonary infiltrate of pneumonic appearance and no evidence of pneumothorax exists in the apical area . Skeletal structure of the thorax demonstrate a moderate degree of demineralization of the vertebral bodies in the thoracic spine with some moderate degree of degenerative changes , but no conclusive evidence of local skeletal destruction .
    OUTPUT:
    
No pulmonary vascular congestion . General pulmonary findings suggestive of COPD without evidence of acute infiltrates . No conclusive findings for any pulmonary malignancy , but as clinical suspicion exists , further evaluation with chest or torso CT may be indicated .