Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are hyperinflated , consistent with COPD . Mild diffuse prominence of interstitial markings may also relate to COPD . The heart is not enlarged . The cardiomediastinal silhouette is within normal limits . No CHF , focal infiltrate , effusion , or pneumothorax is detected . Faint rounded densities seen over lower most portion of both lungs are are not fully characterized on this exam . Otherwise , within limits of plain film radiography , no hilar or mediastinal lymphadenopathy or pulmonary nodules are identified .
    OUTPUT:
    
COPD . Doubt acute pulmonary process . Vague rounded densities over the lower most portion of both lungs , not fully characterized . These could represent artifact due to overlapping vascular and osseous shadows . Based on targeted review of the ___ CT scan , they appear relatively low 2 represent nipple shadows . Consider further assessment with shallow oblique AP radiographs of the chest , with nipple markers , or alternatively chest CT .