Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are relatively hyperinflated , suggesting COPD . There is relative increase in opacity over the left upper lung which could relate to more emphysematous changes in the right lung however , underlying infectious or inflammatory process is not excluded . No large pleural effusion or pneumothorax is seen . Cardiac silhouette size is top - normal . The aorta is calcified and tortuous .
    OUTPUT:
    
COPD with likely pulmonary emphysema . Relative increase in opacity at the left upper lung ; underlying infection or inflammatory process not excluded .