Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . Heart size is accentuated as a result of low lung volumes and appears mildly enlarged . Mediastinal contours are unremarkable . Crowding of the bronchovascular structures is present without overt pulmonary edema . Mild widening of the superior mediastinal contour and fullness of the hilar regions bilaterally is suggestive of underlying lymphadenopathy , as detected on the previous CT . Ill - defined patchy and nodular opacities within the lower lobes bilaterally as well as within the right upper lobe are minimally improved in the interval . Worsening ill - defined nodular , patchy opacities however are noted in the left upper lobe and lingula . No pleural effusion or pneumothorax is present . There are no acute osseous abnormalities .
    OUTPUT:
    
New ill - defined patchy and nodular opacities in the left upper lobe and lingula , and minimal improvement in previously demonstrated ill - defined opacities in both lower lobes and right upper lobe . Findings are compatible with multifocal pneumonia . Reactive lymphadenopathy within the hila bilaterally and mediastinum .