Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: . The patient is status post median sternotomy with wires intact . Cardiomegaly is moderate and accompanied by pulmonary vascular congestion and mild edema . Airspace opacification in the right lower lung is new . An opacity in the left upper lobe is more confluent and increased in extent , now extending centrally to the left paramediastinal region and peripherally to the adjacent pleura where there is a loculated region of pleural fluid or pleural thickening . Volume loss of the left upper lobe of is increased . ICD remains in place with unchanged position of leads . New small bilateral pleural effusions are present , left greater than right .
    OUTPUT:
    
1 . A left upper lobe mass - like opacity is more confluent and increased in extent , concerning for progressive malignancy . 2 . Right lower lung consolidation may reflect asymmetrical edema , aspiration , or infection .