Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: ET tube again seen , tip approximately 2 .3 cm of above the carina , pointing to the right . NG tube present , with tip and side - port overlying the expected site of the fundus . Right IJ central line tip overlies the cavoatrial junction , similar to prior . No pneumothorax detected Allowing for rotated positioning , the cardiomediastinal silhouette is probably unchanged . Again seen are diffuse opacities throughout both lungs . Allowing for technical differences , the extent is quite similar to the prior study , though subtle differences may be present . In particular , the area of confluence in the right mid zone may be slightly improved . Probable small right and possible tiny left pleural effusion . Probable pleural thickening along the left chest wall . , unchanged . Calcification along the right and left hemidiaphragms is again noted .
    OUTPUT:
    
Lines and tubes as described , similar to old 1 day earlier . Diffuse opacities in both lungs , with possible minimal improvement in the right mid zone . The differential diagnosis is extensive and includes infection , atypical pulmonary edema , inflammatory infiltrates , and , in the appropriate clinical setting , ARDS . While the patient may have background chronic changes , given history of IPF , the appearance has progressed compared with ___ , suggesting a superimposed process .