Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heterogeneous opacities in the left upper lobe have progressed in the interval and are now accompanied by confluent airspace opacities in the left perihilar region . Heart remains enlarged , and there is also marked enlargement of the central pulmonary arteries , likely due to pulmonary hypertension in the setting of severe upper lobe predominant emphysema . Small - to - moderate bilateral pleural effusions are also present and may have increased in the interval .
    OUTPUT:
    
Worsening left upper lobe and juxta -hilar opacities , concerning for evolving infectious pneumonia in the appropriate clinical setting .