Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are stable . There is moderate cardiomegaly . The pulmonary arteries are enlarged , this is better seen on prior CT . Bibasilar opacities have increased left greater than right . There is biapical scarring . Pacer leads are in standard position . . There is no pneumothorax or pleural effusion . There are mild degenerative changes in the thoracic spine and wedge - shaped deformities in the thoracolumbar region .
    OUTPUT:
    
Worsening opacities in the lower lobes are worrisome for worsening interstitial lung disease could be acute exacerbation or superimposed pneumonia .