Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear within normal limits . There is no pleural effusion or pneumothorax . Relative lucency at the lung base is suggestive of an unusual pattern of lower - lung predominant severe bullous emphysema . Hyperinflation is present . Aside from unchanged bibasilar scarring , the lungs appear clera . There is no pleural effusion or pneumothorax . Bony structures are unremarkable .
    OUTPUT:
    
1 . Similar findings associated with lower lung predominant but widespread emphysema . With this pattern , alpha - 1 antitrypsin deficiency could be considered as a possibility , but this might be lesser likely given the patient 's age . 2 . No evidence for pneumonia .