Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is upper limits of normal in size . Mediastinal and hilar contours are within normal limits . The aorta is tortuous . The lungs are hyperinflated , consistent with underlying emphysema . Slightly prominent interstitial markings are felt to be reflective of age - related change or small airways disease . Right apical radiation fibrosis is stable . There is a partially calcified right breast prosthesis . No pleural effusion or pneumothorax is identified . The patient is status post bilateral shoulder arthroplasty . Degenerative changes are seen in the thoracic spine .
    OUTPUT:
    
Emphysema . No evidence of focal pneumonia .