Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-upright radiograph of the chest demonstrates hyperexpanded lungs with diffuse coarsened interstitial markings bilaterally , concerning for interstitial pulmonary fibrosis . Interval worsening of a right - sided pleural effusion with adjacent atelectasis . The cardiomediastinal and hilar contours are unchanged . The endotracheal tube ends 4 .6 cm from the carina . Nasogastric tube courses into the stomach . No pneumothorax .
    OUTPUT:
    
1 . Diffuse coarse interstitial markings bilaterally are concerning for interstitial pulmonary fibrosis . 2 . Interval worsening of right - sided pleural effusion with adjacent atelectasis .