Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is within normal limits . The mediastinal contours demonstrate mildly tortuous aorta with calcified atherosclerotic disease at the aortic knob . The lungs demonstrate heterogeneous lucency with coarsening of the interstitial markings as well as hyperinflation and flattening of the hemidiaphragms . These findings are all compatible with COPD . There is no large pleural effusion or pneumothorax .
    OUTPUT:
    
COPD without evidence of pneumonia .