IMPRESSION:
Heart is upper limits of normal size given AP technique.  Mediastinal contours
 are stable.  There are scattered radiopaque nodular opacities within both
 lungs suggestive of prior granulomatous infection.  The perihilar vasculature
 is somewhat prominent.  Small layering bilateral effusions suggestive of mild
 vascular congestion.  No overt pulmonary edema.  No pleural effusions or
 pneumothorax.  No evidence of focal pneumonia.  Degenerative changes in the
 thoracic spine with no acute bony abnormality identified.