Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are severely hyperinflated , in keeping with underlying COPD . There is no focal consolidation , pleural effusion or pneumothorax . A fiducial marker is seen within the right upper lobe . Known pulmonary nodules are better assessed on the dedicated CT chest dated ___ . Cardiomediastinal silhouette is unremarkable . No acute osseous abnormalities identified . Old posterior left rib fractures are noted .
    OUTPUT:
    
Hyperinflated lungs , without evidence of acute intrathoracic process .