Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are new small bilateral pleural effusions . New multifocal patchy opacities in bilateral lungs , most notably in right juxta hilar and bilateral mid and lower lungs , with combined peripheral and peribronchovascular distribution . These findings are superimposed on pre-existing lung parenchymal abnormality is in the left mid and lower lung . Cardiac silhouette is upper limits of normal size limits .
    OUTPUT:
    
New multifocal alveolar and interstitial opacities in association with small bilateral pleural effusions . The differential diagnosis is broad and includes atypical distribution of pulmonary edema , opportunistic infection , or post transplant lymphoproliferative disorder . Considering history of end - stage renal disease , short - term followup radiographs after dialysis may be helpful . If findings fail to improve , chest CT is recommended for further characterization .