Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient is status post median sternotomy and CABG . Cardiac silhouette size remains mildly enlarged . The mediastinal and hilar contours are unchanged . No pulmonary edema is identified . Marked emphysematous changes are re- demonstrated , predominantly within the upper lobes . Chronic interstitial opacities are demonstrated , most pronounced within the lung bases . Scattered calcified granulomas are noted within the left lung . Chronic lateral pleural thickening is again noted bilaterally , along with a small right pleural effusion , not substantially changed in the interval . No focal consolidation or pneumothorax is seen . Multiple remote right - sided rib fractures and right mid clavicular fracture are re - demonstrated .
    OUTPUT:
    
Marked upper lobe predominant emphysema with chronic interstitial opacities at the lung bases . Small right pleural effusion and chronic bilateral pleural thickening . No focal consolidation or pulmonary edema .