Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated . Irregular interstitial markings and increased lucency projecting over the upper lungs suggest underlying COPD . Blunting of the posterior costophrenic angles may be due to small effusions with adjacent atelectasis . Cardiomediastinal silhouette is within normal limits . No acute osseous abnormalities , hypertrophic changes are seen the spine .
    OUTPUT:
    
Hyperinflation with changes suggestive of COPD as well as probable small bilateral pleural effusions .