Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Similar to multiple prior examinations , there is a superimposed accentuation of the prominent interstitial markings , presumably due to underlying interstitial lung disease . There is relative sparing of both lung apices , right more prominent than the left ; however , this may be partially due to underlying emphysematous blebs . The patient 's chin overlies portions of the apices . There is calcified atheromatous plaque at the arch . A large calcified lymph node is noted in the aorticopulmonary window . The cardiac silhouette is enlarged , but stable . There is a right pleural effusion , which results presumably in the blunting of the right costophrenic angle and fluid tracking within the right minor fissure . No left effusion is noted . There is no pneumothorax . Degenerative changes are seen throughout the thoracic spine .
    OUTPUT:
    
Patchy opacities predominantly in the right lower lung and in the left mid and lower lung zones . The pattern mimics that seen on prior radiographs with slightly more confluent opacity on the current study . This may be due to asymmetric distribution of edema due to underlying emphysema or possibly multifocal pneumonia . Correlate clinically . Consider diuresis and short interval followup radiographs to help discriminate the two .