Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette is upper limits of normal in size . Enlarged hila may reflect engorged vessels or enlarged lymph nodes . Widespread heterogeneous pulmonary opacities have worsened since the prior radiographs . There is apparent accompanying bronchial dilation , especially in the juxtahilar regions .
    OUTPUT:
    
Worsening multifocal opacities are concerning for evolving widespread pneumonia in the appropriate clinical setting . Differential diagnosis is broad and includes vasculitis , granulomatous disorders ( sarcoid , granulomatous infection ) and multifocal lung neoplasm . Direct comparison to older chest radiographs would be helpful to determine chronicity . In their absence , consider CT for more complete characterization .