Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded and the hemidiaphragms flattened compatible with history of COPD . Large lucencies in both lungs correspond to bulla seen on CT of ___ . Worsening opacity at the right base likely reflects atelectasis . Consolidations at the left base seen on recent CT of the abdomen and pelvis likely persist but are not well seen on this study . There is scarring and pleural thickening at the lung apices which is minimally worse since ___ . Heart size is normal . Mediastinal and hilar contours are unremarkable . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
1 . Severe COPD . 2 . Opacity at the right base likely reflecting atelectasis . Consolidation at the left base seen on CT the abdomen pelvis ___ not well appreciated on this study . These findings may be accounted for by recurrent episodes of aspiration . 3 . Scarring and pleural thickening at the lung apices is minimally worse since ___ . If patient has symptoms referable to this findings such as Horner 's syndrome , arm or shoulder pain further workup with repeat contrast - enhanced chest CT may be performed .