Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated with flattened diaphragms and increased AP diameter , consistent with COPD . Left greater than right apical pleural thickening is unchanged . No new focal consolidation concerning for pneumonia . Small bilateral effusions are new , as well as pleural fluid thickening the right major fissure . The cardiomediastinal silhouette is stable .
    OUTPUT:
    
Chronic changes of COPD without evidence of new pneumonia .