Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Probable background hyperinflation , suggesting COPD . Allowing for this , there is moderate cardiomegaly , similar to the prior study . The hila are prominent , with a tapered appearance , which could reflect pulmonary hypertension . Hazy opacities seen at both lung bases , likely reflecting bilateral pleural effusions , with underlying collapse and / or consolidation . There is upper zone redistribution and vascular plethora , suggesting mild CHF . Surgical clips noted in the right upper abdomen . Compared with the prior film , the right PICC line has been removed . There is a thin linear density overlying the coursing horizontally over the upper chest . The appearance is not typical for a PICC line or other catheter and this could lie outside the the patient . Clinical correlation is requested .
    OUTPUT:
    
1 . Suspect background COPD . 2 . Moderate cardiomegaly , probably unchanged . Enlarged pulmonary hila raise the possibility of pulmonary hypertension . 3 . Upper zone redistribution and vascular plethora , consistent with CHF . 4 . Probable small left - greater - than - right effusions , with likely underlying collapse and / or consolidation . In the setting , pneumonic infiltrate would be difficult to exclude . 5 . Linear density coursing over upper chest , question outside the the patient . Clinical correlation requested .