Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiomediastinal contour is unchanged . Large retrocardiac hiatal hernia again noted . The bilateral upper lobe predominant peripheral mixed interstitial and alveolar disease process shows no significant interval change compared to previous imaging done ___ . No new areas of airspace consolidation . No pleural effusions . Spondylotic changes of the thoracic spine again noted . Chronic fracture of the superior endplate of L1 again noted . Chronic midshaft fracture of the right clavicle .
    OUTPUT:
    
No significant interval change . No disease progression . This preliminary report was reviewed with Dr . ___ , ___ radiologist .