Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is volume loss at the right lung base with rightward shift of mediastinal structures and streaky new medial right basilar opacification suggesting substantial atelectasis . Pulmonary architecture is highly irregular with relative lucency in the upper lungs , most consistent with emphysema , and the chest appears hyperinflated . Although it may be an artifact associated with the way in which the cardiac and mediastinal structures are rotated to the right , there is a newly apparent convex contour to the right mediastinum . The lateral view suggests very small pleural effusions . There is no pneumothorax . The bones appear demineralized .
    OUTPUT:
    
1 . Severe emphysema . 2 . Streaky new opacification at the right lung base with volume loss , worrisome for atelectasis or perhaps pneumonia . 3 . Small pleural effusions . 4 . Convex right lower mediastinal contour , which may represent enlarged central pulmonary arteries , as suggested before , but since it is difficult to exclude a mass or lymphadenopathy , chest CT is suggested in follow - up , preferably with intravenous contrast , if possible .