Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is normal in size . The mediastinal and hilar contours appear within normal limits . Lung markings are coarse with irregular architecture , suggestive of underlying lung disease . This appearance could be seen with obstructive pulmonary disease , interstitial lung disease or a mixture of both . The prominence of the interstitium makes it difficult to exclude more acute etiologies , however , such as mild vascular congestion , airway inflammation or atypical infection . There is no definite pleural effusion . Diaphragms are flattened , however , so subpulmonic effusions are not excluded , although the finding may relate to hyperinflation .
    OUTPUT:
    
Coarse irregular lung architecture suggesting underlying lung disease . No definite superimposed process , but vascular congestion , airway inflammation or atypical infection may be involved with this appearance .