Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Diffuse coarse interstitial reticular opacities are again demonstrated , consistent with widespread pulmonary fibrosis . Although diffusely distributed , this relatively spares the apices . Slightly more confluent opacities are present within the right middle lobe and lingular regions , partially obscuring both heart borders . Additionally , a somewhat nodular opacity projects over the right third anterior rib level . Cardiomediastinal contours are stable in appearance with normal heart size and pulmonary vascularity . No pleural effusion . Diffuse bone demineralization and thoracic spine compression deformities are unchanged since ___ .
    OUTPUT:
    
1 . Pulmonary fibrosis , with no superimposed findings to suggest clinically suspected congestive heart failure . Given the diffuse distribution and presence of coexisting air trapping on prior CT of ___ , chronic hypersensitivity pneumonitis should be considered as a potential etiology . 2 . Slightly more confluent opacities in right middle lobe and lingula as well as a nodular opacity in the right upper lobe may reflect confluent areas of fibrosis , but superimposed infection should be considered in the appropriate clinical setting . Followup radiographs may be helpful after antibiotic therapy if warranted clinnically , as entered into the radiology communications dashboard on ___ . If the nodular opacity in the right upper lobe persists on follow up CXR , CT may be considered to exclude a lung nodule .