Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperinflated , suggesting chronic obstructive pulmonary disease . There is a subtle rounded density projecting over the anterior right fifth rib which may relate to the edge of the anterior rib , although underlying pulmonary nodule is not excluded . No prior is available for comparison . Biapical pleural thickening is seen . No pleural effusion or pneumothorax is seen . The cardiac and mediastinal silhouettes are unremarkable . No pulmonary edema .
    OUTPUT:
    
Hyperinflated lungs , suggesting chronic obstructive pulmonary disease . Subtle rounded density projecting over the anterior right fifth rib which may relate to the edge of the anterior rib , however , underlying pulmonary nodule is not excluded . Recommend shallow oblique views or nonurgent chest CT for further evaluation .