IMPRESSION:
Cardiomediastinal silhouette is unchanged. There is interval improvement in
 the left lung variation but unchanged appearance of the right lung. 
 Port-A-Cath catheter tip is at the cavoatrial junction.  A left pacemaker lead
 is in the right ventricle. Interstitial opacities projecting over the lung
 bases, right more than left are consistent with known interstitial lung
 disease with most likely superimposed pulmonary edema.  No focal consolidation
 to suggest pneumonia is can see in