Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are small bilateral pleural effusions . The lungs otherwise remain hyperinflated , suggesting chronic obstructive pulmonary disease . Right greater than left upper to mid lung peripheral patchy opacities again noted . No pneumothorax is seen . The cardiac and mediastinal silhouettes are stable .
    OUTPUT:
    
Persistent small bilateral pleural effusions . Right greater than left upper to mid lung peripheral patchy opacities again noted . As on the prior study , nonurgent chest CT follow - up was recommended , and this recommendation remains .