FINDINGS:
Median sternotomy wires and prosthetic mitral valve are in unchanged
 positions.  Lumbar kyphoplasty is again noted.  Widened mediastinum and
 increased interstitial markings in bilateral perihilar regions are similar to
 before and consistent with interstitial lung disease which was better
 evaluated on prior CT.
 
 Lung volume is low.  No new area of consolidation is identified.  There is no
 pleural effusion or pneumothorax.  Mildly enlarged cardiac silhouette is
 unchanged.

IMPRESSION:
No radiographic evidence of pneumonia.  Chronic interstitial lung disease
 appears similar to .