Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral chest radiograph demonstrates hyperinflated lungs with flattening of the diaphragms and basilar predominance . Persistent left upper lobe opacity may represent a component of overlapping shadows however can not exclude pulmonary nodule . Areas of bronchial wall thickening and bronchiectasis are similar to previous examination . No pleural effusion or pneumothorax . Heart size , mediastinal contour , and hila are unremarkable . Limited assessment of the upper abdomen is within normal limits .
    OUTPUT:
    
1 . Hyperinflated lungs with basilar predominance is most consistent with emphysema and areas of air trapping in the lower lobes however differential includes also 1 antitrypsin deficiency . 2 . Persistent left upper lobe opacity may represent overlapping shadows however can not exclude pulmonary nodule . Recommend shallow oblique views for further evaluation . 3 . Areas of bronchial wall thickening and bronchiectasis , similar to previous examination can be seen with small airway disease and / or bronchitis in the appropriate clinical setting . 4 . No evidence of pneumonia .