Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . Mediastinal contours are noted . Patchy opacity within the left lower lobe is concerning for aspiration or pneumonia . Upper lobe predominant emphysema is re - demonstrated . Fibrosis with bronchiectasis in the lung apices is unchanged . No pleural effusion , pulmonary vascular congestion , or pneumothorax is seen . There are no acute osseous abnormalities .
    OUTPUT:
    
Patchy left lower lobe opacity concerning for aspiration or pneumonia . Fibrosis with bronchiectasis in the upper lobes and emphysema .