Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are diffuse background increased interstitial markings consistent with known interstitial lung disease . This appears similar compared to the prior examination . A tracheostomy tube is noted . The heart is enlarged . There is no pneumothorax or effusion .
    OUTPUT:
    
Similar appearance of the lungs with diffusely increased interstitial markings reflecting chronic interstitial lung disease . A superimposed pneumonia would be difficult to exclude .