Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . Mediastinal contour is unchanged . Right upper and lower lobe perihilar consolidative opacities are again demonstrated with continued increased interstitial markings in the right lower lobe , not substantially changed in the interval allowing for differences in modalities . Right lateral and basilar pleural thickening is also similar . The left lung is clear . No pulmonary edema , left - sided pleural effusion , or pneumothorax is present . Moderate degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
No definite interval change in right upper and lower lobe perihilar consolidative opacities which remain concerning for malignancy with continued right lateral and basilar pleural thickening . Increased interstitial markings in the right lower lobe remain concerning for lymphangitic spread of tumor .