Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated with irregular interstitial markings compatible with patient 's known emphysema . The previously seen cavitary lesions in the left upper lobe and right middle lobe as well as the left lower lobe focal opacity are again seen . There may be new superimposed opacity in the right middle lobe . No definite interval change given differences in technique . The cardiomediastinal silhouette is within normal limits . No acute osseous abnormalities .
    OUTPUT:
    
Focal opacities in the left upper lobe , right middle lobe , and left lower lobe are not significantly changed since recent CT scan . Possible new focal opacity in the right middle lobe which could represent a superimposed acute infection .