Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: When compared to the prior , there is no significant interval change . Increased interstitial markings which is more extensive on the left when compared to the right is again seen compatible with patient 's known chronic lung disease . There is no superimposed acute consolidation . The cardiomediastinal silhouette is stable given differences in positioning . Median sternotomy wires and mediastinal clips are noted . Severe degenerative changes are seen at the left shoulder . Surgical clips in the right upper quadrant and at the thoracic inlet are again noted .
    OUTPUT:
    
Chronic changes in the lungs without definite superimposed acute cardiopulmonary process , noting that subtle change could easily be obscured .