Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated and with increased AP diameter , suggesting chronic obstructive pulmonary disease . No focal consolidation is seen . There is no pleural effusion or pneumothorax . The cardiac and mediastinal silhouettes are unremarkable . Subtle retrocardiac air - fluid level is most consistent with a hiatal hernia . The bones are diffusely osteopenic .
    OUTPUT:
    
COPD . No focal consolidation to suggest pneumonia . Hiatal hernia .