Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided the AICD / pacemaker device is noted with leads terminating in the right atrium and right ventricle , unchanged . Right Port - A - Cath tip terminates in the lower SVC , unchanged . Mild enlargement of the cardiac silhouette is again noted with left ventricular predominance . The mediastinal contour is unchanged with mild rightward deviation of the trachea again noted . Extensive , chronic parenchymal opacities with architectural distortion and bronchiectasis are noted bilaterally , most pronounced in the right upper and left lower lung fields , not substantially changed in the interval , with slight increased atelectasis in the right upper lobe . Remote right - sided rib fractures are again noted . No pneumothorax or pleural effusion is clearly evident . Mild degenerative changes are again noted in the thoracic spine .
    OUTPUT:
    
Chronic diffuse parenchymal abnormality predominantly characterized by marked bronchiectasis and scarring , most pronounced in the right upper lobe and left lung base , compatible with cystic fibrosis , and not substantially changed in the interval . No new areas of parenchymal opacification clearly identified .