Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated and the diaphragms are flattened , consistent with COPD . The patient is status post sternotomy , with interruption of the uppermost sternal wire again seen . The cardiomediastinal silhouette is unchanged , without evidence of cardiac enlargement . There is no CHF . The patient has known chronic background interstitial and fibrotic changes . On today 's examination , there are changes in the right upper and mid zones and in both bases . The patchy opacity in the right mid zone laterally is , however , new or more pronounced compared with ___ . Bibasilar changes are similar to the prior radiograph . No frank consolidation and no effusion is identified . Advanced degenerative changes in the thoracic spine again noted .
    OUTPUT:
    
1 . No frank consolidation . However , some patchy opacity at the right mid zone laterally is new or significantly more pronounced than on ___ . This could represent an early infectious infiltrate . Attention to this area on followup films to exclude progression is requested . 2 . Bibasilar atelectasis / scarring and probable scarring the right upper zone laterally is again noted , similar to the prior film .