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 . Underlying interstitial disease is suspected with peripheral reticulation . More confluent but irregular opacities are noted in each lower lung , particularly in the left lower lung , involving the lingula and probably the left lower lobe . A small right apical nodular opacity measures about 4 mm in diameter . A more vague 4 mm nodular opacity is also identified in the left upper lung . Mild biapical pleural thickening may be accompanied by a small bulla at the right apex . A trace pleural effusion is suspected on the left . Mild degenerative changes and exaggerated kyphosis are noted along the thoracic spine with small anterior osteophytes .
    OUTPUT:
    
1 . Findings suggesting underlying interstitial lung disease . 2 . Bibasilar opacities may represent superimposed pneumonia , although chronicity of findings is uncertain without prior radiographs for comparison . 3 . Possible trace pleural effusion on the left . 4 . Possible nodules . In addition to clinical correlation including pulmonary consultation , it may be appropriate to consider chest CT in follow - up to evaluate for nodules and the nature of suspected underlying disease if needed clinically .