Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided AICD is again seen , similar position . The lungs remain hyperinflated with relative lucency of the upper lobes , consistent with chronic obstructive pulmonary disease and pulmonary emphysema . Cardiac and mediastinal silhouettes are stable . There is no focal consolidation , pleural effusion , or evidence of pneumothorax .
    OUTPUT:
    
No acute cardiopulmonary process . COPD , pulmonary emphysema .