Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal and unchanged . The mediastinal contours are similar . Superior retraction of the hila with architectural distortion , volume loss and coarse interstitial opacities with bronchiectasis and scarring in the upper lobes appear grossly unchanged . Additional coarse interstitial opacities are noted within both mid and lower lung fields with ring shadows , likely reflective of airway wall thickening , bronchiectasis and small airways disease . Blunting of the costophrenic angles bilaterally is compatible with small pleural effusions . There is likely mild pulmonary vascular congestion . No pneumothorax is present . There are no acute osseous abnormalities .
    OUTPUT:
    
1 . Chronic changes within the upper lobes bilaterally suggestive of prior granulomatous disease . 2 . Coarse interstitial opacities within the remainder of the lungs bilaterally , slightly worse in the interval , with airway wall thickening and bronchiectasis likely reflects acute on chronic airways infection and inflammation , perhaps related to atypical mycobacterial infection . 3 . Small bilateral pleural effusions and possible mild pulmonary vascular congestion .