Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No interval change since radiograph performed 4 hours prior . Again seen are well inflated lungs . Persistent heterogeneous granular opacities within bilateral lung bases noted . Lucencies projecting along the right costophrenic angle and lateral right pleural surface are consistent with blebs . Pleural plaques again noted . There is evidence of severe emphysema . Persistent moderate left basilar pneumothorax is unchanged in size or appearance . No pleural effusion . Heart size , mediastinal contour , and hila are unremarkable . Aortic arch calcifications are present . A right anterior chest wall pacer device with single lead tip within right ventricle again noted .
    OUTPUT:
    
1 . No significant change in moderate left basilar pneumothorax . 2 . Severe emphysema 3 . Progression of bibasilar opacities are worrisome for aspiration or aspiration pneumonia 4 . Pleural plaques consistent with prior asbestosis exposure .