Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are provided . The lungs appear clear , though there are emphysematous changes again noted . No definite signs of pneumonia , CHF , pleural effusion , or pneumothorax . The cardiomediastinal silhouette appears stable . Bony structures are intact .
    OUTPUT:
    
Emphysema without superimposed pneumonia .