Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest again demonstrate marked peripheral reticular interstitial markings . The right upper lobe apical scarring has particularly worsened since the prior study . Heart and mediastinal contours are normal . No effusion and no pneumothorax . No new nodules are identified and no obvious evidence of acute pneumonia .
    OUTPUT:
    
Widespread parenchymal abnormalities , progressed since the prior study , particularly in the right upper lobe . Would recommend a CT for evaluation of interstitial disease and for baseline for nodules as the underlying parenchymal disease makes it difficult to evaluate for this .