Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size , mediastinal and hilar contours are normal . Lung volumes are low , accentuating the bronchovascular structures . This may account for an apparent new interstitial abnormality in the lungs , superimposed upon chronic upper lobe predominant emphysema . No confluent areas of consolidation are observed , and there are no pleural effusions or acute skeletal findings .
    OUTPUT:
    
Questionable new diffuse interstitial abnormality , possibly due to crowding of normal bronchovascular structures related to low lung volumes . Repeat radiograph with improved inspiratory level would be helpful to exclude a true interstitial process such as atypical pneumonia or interstitial edema .