Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Rotated supine positioning . Rotation limits direct comparison to the prior film , peptic could for assessment of the cardiomediastinal silhouette . Allowing for this , the enlarged cardiomediastinal silhouette is probably similar to the prior film . The enlarged There is upper zone redistribution and diffuse vascular plethora . Allowing for technical differences , this may be slightly worse than on the prior film . Although there is suggestion of vascular blurring as can be seen with interstitial edema , this could be accentuated by under penetrated technique and overlying soft tissues . Again seen is deformity and pleural thickening along the right chest wall of indeterminate acuity . The right costophrenic angle is excluded from the film . Left the extreme left costophrenic is obscured by overlying soft tissues .
    OUTPUT:
    
Limited exam , particularly to assess for interval changes , given considerable differences in technique and positioning . The cardiomediastinal silhouette and pulmonary hila remain enlarged , similar to prior . There is prominent upper zone redistribution and diffuse vascular plethora , probably slightly more pronounced than on the prior film , given technical limitations . No definite increase in the degree of interstitial edema , given overlying soft tissues and underpenetration . The costophrenic sulci are not well visualized . Allowing for this , no gross effusion .