Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal contours are within normal limits . The lungs are hyperinflated , consistent with known diagnosis of COPD . Increased pulmonary markings likely reflect chronic changes . There is upper lobe scarring with tenting of the hila bilaterally . There is no focal consolidation or pneumothorax . Posterior basal opacity , seen best on the lateral view , is unchanged and could represent a small pleural effusion or a Bochdalek hernia .
    OUTPUT:
    
No acute cardiopulmonary process .