Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs remain hyperinflated , suggesting chronic obstructive pulmonary disease . There is biapical pleural thickening , possibly slightly more increased as compared the prior study . The trachea remains deviated to the right , stable as compared to ___ possibly due to underlining goiter . No pleural effusion is seen . The cardiac and mediastinal silhouettes are stable .
    OUTPUT:
    
Possible increased opacity at the right lung apex , correlate with follow - up chest CT . COPD .