Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . The lungs are hyperinflated with biapical pleural parenchymal scarring a again noted . No focal consolidation concerning for pneumonia . No edema . The heart is within normal limits of size . The mediastinal contour is normal . No pleural effusion or pneumothorax . Mild dextroscoliosis of the lower T - spine again noted . PEG tube projects over the left upper quadrant .
    OUTPUT:
    
COPD without superimposed acute process .