Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided Port - A - Cath tip terminates in the proximal right atrium , similar compared to the prior study . The cardiac , mediastinal and hilar contours are unchanged , with the heart size top normal . The aorta remains tortuous . Radiation fibrotic changes in the right upper lobe and superior mediastinal region is stable . There is hyperexpansion of the lungs with flattening of the diaphragms compatible with underlying chronic obstructive pulmonary disease . No new areas of consolidation are demonstrated . There is no pleural effusion or pneumothorax . There are multilevel degenerative changes in the thoracic spine . Small hiatal hernia is again noted .
    OUTPUT:
    
No significant interval change from the prior exam . No acute abnormality seen including no evidence for pneumonia or congestive heart failure .