Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral views of the chest provided . Spinal fusion hardware is again seen extending from the mid chest inferiorly . Tiny surgical clips again seen projecting over the right apex with adjacent suture material . Patient is known to have severe emphysema . Chronic left effusion and adjacent rounded atelectasis persists . There is minimal increased reticular opacity in the left mid lung which appears increase in overall conspicuity from the prior exam though appears most suggestive of scarring . No pneumothorax is seen . Overall cardiomediastinal silhouette is stable . Bony structures appear intact .
    OUTPUT:
    
Chronic changes including chronic consolidation in the left lower lung likely rounded atelectasis with chronic left effusion . Emphysema with increased scarring in the left mid lung . No pneumothorax .