Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Apical pleural thickening is again noted , grossly unchanged from prior study . Lungs are hyperinflated with prominent retrosternal clear space , likely due to underlying COPD . There is no focal consolidation , effusion , or pneumothorax . The cardiomediastinal silhouette is normal . Imaged osseous structures are intact . No free air below the right hemidiaphragm is seen . Again seen is a mild anterior wedge deformity in the mid thoracic spine , grossly unchanged from comparison study .
    OUTPUT:
    
COPD without superimposed acute process . Prominent apical scarring . Consider nonemergent outpatient CT to further assess given extensive background emphysema .