Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with flattening of diaphragms . Right lower lobe peribronchial wall thickening is noted . Small left pleural effusion . No right pleural effusion . No pneumothorax . Moderate aortic knob calcifications with tortuous aorta . Stable mild cardiomegaly . Mediastinal contour and hila are unremarkable . A left pacer device lead tips are in the right atrium and right ventricle . Limited evaluation of the osseous structures are notable for multilevel degenerative changes
    OUTPUT:
    
1 . Early right lower lobe pneumonia . 2 . Emphysema or chronic obstructive pulmonary disease . 3 . Small left pleural effusion .