Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated and associated with flattening of the diaphragms . No consolidation , effusion , or pneumothorax is present . A 4 - mm right apical granuloma is noted . DISH is incidentally noted in the thoracic spine .
    OUTPUT:
    
Hyperinflated lungs and flattened diaphragms consistent with COPD .