Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the study of ___ , there is little overall change . Hyperexpansion of the lungs with coarse interstitial markings are consistent with chronic pulmonary disease . No evidence of acute focal pneumonia . Blunting of the costophrenic angle on the right is again seen , most likely related to scarring or chronic pleural thickening . Tortuosity of the aorta is again noted .
    OUTPUT:
    
No interval change and no evidence of acute pneumonia in this patient with findings consistent with chronic obstructive pulmonary disease .