Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate to severe cardiomegaly is re - demonstrated . Mediastinal and hilar contours are unchanged . Diffuse severe bronchiectasis , most pronounced within the upper lobes , with architectural distortion is compatible with the patient 's known history of cystic fibrosis . There is persistent collapse and consolidation of the right upper lobe and lingula , findings which appear relatively unchanged compared to the previous exams . Slight rightward shift of the trachea likely reflects volume loss in the right lung . No pulmonary vascular congestion is demonstrated . Patchy opacities within the right lung base and left mid lung field appear slightly worse in the interval . There is a possible small left pleural effusion . No pneumothorax is identified . Remote right - sided rib fracture is noted .
    OUTPUT:
    
Extensive bronchiectasis with chronic right upper lobe and lingular collapse and consolidation . Patchy opacities in the left mid and right lung base appear progressed in the interval , which is concerning for worsening airways infection or inflammation . Possible small left pleural effusion .