Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to ___ at 01 :27 and allowing for technical differences , the medial left hemidiaphragm is slightly less distinct . Otherwise , I doubt significant interval change . An AICD type device and leads are unchanged . Abandoned leads also noted . Cardiomediastinal silhouette with sternotomy wires , is unchanged . Background COPD with hyperinflation again noted . Patchy increased interstitial markings are present in both lungs . These could represent a combination of chronic fibrotic changes and / or superimposed edema . Again seen is blunting of both costophrenic angles . In this setting , superimposed infectious infiltrates would be difficult to exclude .
    OUTPUT:
    
Extensive interstitial markings again seen in both lungs , most pronounced at the bases . The medial left hemidiaphragm is slightly less distinct than on the prior film , raising the question of more confluent opacification in this area . Otherwise , I doubt significant interval change