FINDINGS:
PA and lateral views of the chest are compared to previous exam
 from .  As on prior, there are increased interstitial opacities
 throughout the lungs bilaterally.  These appear to have progressed since the
 previous exam even given differences in technique.  There is  no significant
 volume loss in the lungs, nor confluent consolidation.  There is no effusion. 
 Cardiac silhouette is enlarged, slightly more so than when compared to prior. 
 Osseous and soft tissue structures are unremarkable.

IMPRESSION:
1.  Increased interstitial markings in the lungs bilaterally which could
 represent patient's known chronic underlying lung disease with a component of
 interstitial edema not excluded.  No confluent consolidation.
 2.  Mild cardiomegaly, which has enlarged since prior exam.