Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The previously seen hilar abnormality is likely tortuous and enlarged pulmonary vasculature , which may be related to underlying pulmonary hypertension . The size of the cardiac silhouette is mildly enlarged . Hyperinflation , flattened hemidiaphragms , and parenchymal scarring suggest severe underlying COPD . Chronic re-distribution of the pulmonary vasculature is noted . There is no consolidation , edema , pleural effusion , or pneumothorax . A fluid level is visible in the left breast and compatible with post-surgical changes from the recent breast surgery .
    OUTPUT:
    
1 . No acute cardiopulmonary process . 2 . Severe COPD . 3 . Previously seen hilar abnormality is likely tortuosity and enlargement of the pulmonary arteries , suggesting pulmonary hypertension . 4 . Mild cardiomegaly . 5 . Post - surgical changes in the left breast . Results were discussed with Dr . ___ at 5 : 10 p .m . on ___ via telephone by Dr . ___ .