Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Allowing for technical differences , no gross change . Again seen are multi focal small nodular opacities throughout both lungs , most pronounced in the right upper and right mid zones . The degree of involvement in the right upper zone is equivocally slightly worse and changes at the right lung base ( right middle lobe ) are slightly less confluent . The cardiomediastinal silhouette is probably unchanged , with note made of mediastinal and hilar lymph adenopathy identified by CT . Known ectatic ascending aorta seen is slight unfolding of the aorta on this examination . No pneumothorax or effusion is identified . Incidental note made of severe right and probable mild - to - moderate left glenohumeral joint osteoarthritis .
    OUTPUT:
    
Persistent multifocal nodular opacities in both lungs , somewhat asymmetric . Possible slight worsening in the right upper zone and slight improvement in the right middle lobe . As previously suggested , the differential includes multifocal pneumonia , other inflammatory processes or metastasis . Changes in the right middle lobe raise concern for postobstructive pneumonia with superimposed atelectasis .