Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are stable with mild cardiomegaly and tortuous aorta . The lungs are hyperinflated consistent with COPD . Left lower lobe opacities are unchanged . Right apical scarring is unchanged . Nodular opacity in the left lower lobe seen in the frontal view is likely superimposition of normal structures . There is no pneumothorax or pleural effusion . There are moderate degenerative changes in the thoracic spine
    OUTPUT:
    
Left lower lobe opacities are grossly unchanged likely atelectasis . Nodular opacity seen in the frontal view likely represents superimposition of normal structures . CT is recommended for further evaluation COPD