Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Continued enlargement of the cardiac silhouette with mild tortuosity of the aorta . No evidence of vascular congestion or pleural effusion . Hyperexpansion of the lungs is consistent with chronic pulmonary disease . However , no evidence of acute pneumonia . Wedging of several thoracic vertebra is stable . Central catheter again extends to the upper to midportion of the SVC .
    OUTPUT:
    
Little change and no evidence of acute cardiopulmonary disease . Hyperexpansion of the lungs is consistent with chronic lung disease .