Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is probable background hyperinflation / COPD . There is mild cardiomegaly . The aortic and hilar contours are obscured by the surrounding parenchymal changes . There are extensive increased interstitial markings in both lungs , with more honeycomb appearance in the right upper zone . The appearance is suggestive of chronic parenchymal scarring , but the possibility of a superimposed interstitial process or interstitial edema would be difficult to exclude . Probable background blebs and bullae in both lungs . Minimal blunting of left - greater - than - right costophrenic angles . Increased retrocardiac opacity , also of uncertain etiology or acuity . Asymmetric left apical pleural thickening noted . A metallic BB overlies the right lung base . Based on this single frontal view , this could either lie within or outside of the the patient . Probable background osteopenia . There is an apparent ununited fracture of the lateral portion of the right clavicle at the level of the coracoid . No displacement or elevation is appreciated .
    OUTPUT:
    
1 . Probable background COPD , with extensive parenchymal scarring and bulla formation , not fully evaluated by radiograph . 2 . Diffuse increased interstitial markings in both lungs . While these likely represent chronic changes , the possibility of an acute superimposed interstitial process including , but not limited to CHF , can not be excluded . 3 . Mild cardiomegaly . 4 . Asymmetric pleural thickening at the left lung apex . Correlation with previous ( outside ) radiographs is recommended to exclude developing neoplasm . If not available , then further assessment with CT would be recommended . 5 . BB over right lung base --___ within or outside the the patient . If MRI is contemplated , then a lateral view may help to further characterize this . 6 . Ununited non display right clavicle fracture noted .