FINDINGS:
Interstitial disease is redemonstrated more prominent in the right upper
 subpleural location laterally as well as to a lesser extent in the right lower
 lung.  Compared with prior examination there is interval increase in
 interstitial markings, not specific but suggesting superimposed fluid
 overload; it may also be the case that underlying interstitial disease has
 progressed. There are also patchy opacities in the right cardiophrenic angle
 concerning for infectious or inflammatory process.  No pleural effusion is
 identified.  There is no pneumothorax.  Aortic vascular calcifications are
 again seen. The heart is mildly enlarged.

IMPRESSION:
1.  Patchy opacities in the right cardiophrenic angle raise concern for
 pneumonia.
 
 2.  Compared with the previous exam from , the worsening appearance of the
 interstitial disease along with vascular congestion suggest mild vascular
 congestion and/or worsening interstitial disease with concern for pneumonia at
 the right lung base.