Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive bullous emphysema is seen most pronounced in the lung apices . The lungs are hyperinflated . Heart size is within normal limits . The mediastinal and hilar contours are unchanged . Clip in the right hilum appears unchanged . Interstitial abnormality within the lung bases appears chronic . No focal consolidation is demonstrated . There is no pneumothorax , pleural effusion , or evidence of pulmonary vascular congestion . Cholecystectomy clips are seen within the right upper quadrant the abdomen . No endotracheal tube is identified .
    OUTPUT:
    
Severe bullous emphysema without acute cardiopulmonary abnormality . No endotracheal tube is identified .