Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are again hyperinflated with flattening of the diaphragms consistent with obstructive lung disease . Chronic interstitial markings bilaterally are again seen , consistent with chronic lung disease . Right apical thickening pleural thickening is stable . The heart size is normal . The hilar and mediastinal contours are normal . No focal consolidations concerning for pneumonia are identified . There is no pleural effusion or pneumothorax .
    OUTPUT:
    
Stable emphysema and coarse interstitial markings . No acute intrathoracic abnormalities identified .