FINDINGS:
Left PICC is identified elbow tip is not clearly delineated. Persistent
 retrocardiac opacity is again seen as well as increased interstitial markings
 throughout the lungs. The cardiomediastinal silhouette is unchanged. Pulmonary
 nodules are better seen on prior CT scan. Expansile lytic lesion of the left
 lateral fourth rib there is again noted. Posterior fixation hardware seen in
 the visualized lumbar spine.

IMPRESSION:
Retrocardiac opacity potentially atelectasis although infection is also
 possible. Increased interstitial markings throughout the lungs could be from
 chronic interstitial process potentially with superimposed interstitial edema.
 Lytic expansile lesion of the left fourth again seen. Pulmonary nodules are
 better identified on prior CT scan.