Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Upper lobe predominant ground - glass and nodular opacities and heterogeneous consolidation have increased when compared to the prior examination . In the cardiac silhouette also remains enlarged with a abnormal left ventricular contour . No pleural effusions or pneumothorax .
    OUTPUT:
    
Interval increase in the upper lobe predominant nodular opacities can be atypical infection or pulmonary alveolar proteinosis , given the persistent radiographic findings . Pericardial effusion or unusual cardiac configuration .