Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Numerous bilateral mediastinal and hilar calcified lymph nodes are again seen without significant interval change . Biapical scarring with upward retraction of the hila is unchanged . The lungs remain hyperinflated , with flattening of the diaphragms . Since the prior study , there has been increased blunting of the left costophrenic angle which may be due to a small pleural effusion . Left base retrocardiac opacity may be due to combination of pleural effusion and atelectasis in underlying consolidation is not excluded . A trace right pleural effusion be difficult to exclude . The cardiac silhouette is stably enlarged . Calcified breast implants are seen overlying the lower thorax bilaterally . Partially imaged is a right humeral prosthesis .
    OUTPUT:
    
Interval blunting of the left costophrenic angle and development of left base retrocardiac opacity may be due to combination of pleural effusion and atelectasis although an underlying consolidation is not excluded . Difficult to exclude trace right pleural effusion . Stable chronic changes consistent with sarcoidosis including numerous calcified mediastinal and hilar lymph nodes , upward retraction of the hila and scarring in the upper lobes and to a lesser extent bibasilar scarring . Hyperinflated lungs suggest chronic obstructive pulmonary disease .