Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are clear , without focal airspace consolidation to suggest pneumonia . Heart size is enlarged and lungs are hyperinflated , unchanged from prior . There are small bilateral pleural effusions , again unchanged . There is no pneumothorax . The mediastinal silhouette is unremarkable .
    OUTPUT:
    
Unchanged , small bilateral pleural effusions . COPD .