Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal and hilar contours are stable . The left costophrenic angle is not captured on this study , however , there does not appear to be a large pleural effusion . There is no pneumothorax . Diffuse increased interstitial markings with paucity of vessels in some areas is consistent with interstitial and emphysematous disease . There is no focal consolidation concerning for pneumonia . Surgical clips in the right axilla are indicative of prior axillary lymph node dissection . Degenerative changes of the right glenohumeral joint are noted .
    OUTPUT:
    
No acute cardiopulmonary process . Chronic fibrotic and emphysematous changes again noted .