Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A Port - A - Cath terminates in the upper right atrium . The cardiac , mediastinal and hilar contours appear unchanged . Fine reticulation associated with pulmonary fibrosis appears very similar within each lung in extent and distribution with no significant superimposed change . The lung volumes are low . There is no pleural effusion or pneumothorax . Multiple compression deformities including lower thoracic vertebroplasties appear unchanged .
    OUTPUT:
    
No evidence of acute disease . Severe pulmonary fibrosis , not significantly changed .