Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: This radiograph was read in conjunction with most recent CT from ___ . Again seen is moderate to severe centrilobular emphysema predominantly in the upper lobes , though present elsewhere . Heart size is within normal limits . Mediastinal and hilar contours are unremarkable . There is no evidence for pulmonary edema , pulmonary consolidation , pleural effusion , or pneumothorax . Aortic knob calcification seen .
    OUTPUT:
    
Moderate to severe centrilobular emphysema , worse in the upper lobes . No acute pneumonia .