Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is normal with mild tortuosity of the thoracic aorta . Cardiomediastinal silhouette and hilar contours are normal . Lungs are severely hyperinflated with lucent parenchyma and apparent prominent margination of the vasculature compatible with severe emphysema , unchanged from prior study . No focal consolidation is seen . Pleural surfaces are clear without effusion or pneumothorax . Bones are diffusely demineralized with contour irregularities on the left compatible with multiple old healed rib fractures .
    OUTPUT:
    
1 . No acute cardiopulmonary abnormality , specifically no pneumothorax . History of right apical nodule , better seen on CT . 2 . Severe emphysema .