Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No previous chest x-rays on PACS record for comparison . The heart is not enlarged . There is no CHF , focal infiltrate , or effusion . I suspect the presence of some bullous change at the lung apices . However , no fibronodular scarring or apical retraction is identified . Within the limits of plain film radiography , no hilar or mediastinal lymphadenopathy , pulmonary nodules , or calcified lymph nodes are detected . Osseous structures are grossly unremarkable .
    OUTPUT:
    
1 . No acute pulmonary process identified . 2 . No radiographic evidence of pulmonary tuberculosis is detected . 3 . Suspect bullous change at both lung apices . If clinically indicated , this could be further assessed with chest CT .