Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: As on the prior study the lungs are hyperexpanded with architectural distortion . There is chronic consolidation in the right upper lobe posteriorly . No new focal opacities detected to suggest pneumonia . There is no pleural effusion or pneumothorax . Heart size is normal . The mediastinal and hilar contours are stable . There are surgical clips in the right breast / axilla .
    OUTPUT:
    
Chronic changes including emphysema but no evidence of pneumonia .