Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again , the lungs are hyperinflated with flattening of the diaphragms . Coarsened interstitial markings are chronic , likely related to COPD . There is no focal airspace opacity , pulmonary edema , pleural effusion , or pneumothorax . The cardiomediastinal silhouette is normal .
    OUTPUT:
    
Stable changes of COPD . No radiographic evidence of pneumonia .