FINDINGS:
PA and lateral views of the chest were provided.  The lungs are
 hyperinflated with widened AP diameter of the chest, which likely reflects
 underlying COPD.  There is blunting of the CP angles bilaterally which is
 compatible with small pleural effusion.  Relative prominence of the hilar
 vascular structures raises potential concern for pulmonary arterial
 hypertension.  Please correlate clinically.  The heart size is within normal
 limits.  The mediastinal contour appears normal.  There is no pneumothorax. 
 Bony structures are intact.

IMPRESSION:
COPD with tiny bilateral effusions.  Possible pulmonary arterial
 hypertension accounting for the relative enlargement of the hilar vascular
 structures.