Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The appearance in the right lung has worsened with increased right lower lobe infiltrate and increased nodular opacities . Some of these may be true nodules , or infection or neoplasm . There is also increased effusion on the right . the left lung is relatively clear . the heart is slightly enlarged . There is ill definition of the mediastinum suggesting vascular engorgement although given history lymphadenopathy could also be contributing to this appearance .
    OUTPUT:
    
Worsened appearance to the chest with new right lower lobe infiltrate . Rapid change in findings suggests that most of the new appearance is due to infectin or fluid overload . An underlying neoplastic process should be assessed for after resolution of acute symptoms .