Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The cardiomediastinal and hilar contours are within normal limits . The thoracic aorta is tortuous . The pulmonary artery is enlarged suggesting pulmonary hypertension . The lungs are hyperinflated consistent with emphysema . Opacities involving the bilateral lower lobes and within the right middle lobe could represents infection and are best appreciated on the lateral view . A focal rounded opacity in the left mid lung is seen . There is no pneumothorax or large pleural effusion .
    OUTPUT:
    
Bilateral lower lobe and right middle lobe opacities are worrisome for atypical infection . Hyperinflated lungs consistent with emphysema . Focal rounded opacity projected over the left mid lung is possibly due to a nipple shadow but not fully characterized . Recommend followup chest x-ray in 4 weeks after completion of antibiotic therapy to assess for resolution of multifocal opacities suggestive of pneumonia . Placement of nipple markers on the followup exam will also help localize the left mid lung nodular opacity .