Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest radiographs are obtained . Extensive pulmonary fibrosis and bronchiectasis is grossly similar to the prior exams . There is no suggestion of a new consolidation . There is no effusion or pneumothorax . Moderate cardiomegaly is unchanged . Enlargement of the aortic arch continues to deviate the calcified trachea rightward . There is a large hiatal hernia . Severe degenerative changes of the left shoulder are again seen . The chest wall remains deformed .
    OUTPUT:
    
Grossly similar appearance of diffuse pulmonary fibrosis and bronchiectasis . Superimposed infection can not be excluded .