Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate cardiomegaly is unchanged . Atherosclerotic calcifications of the aortic knob are again demonstrated . Hilar contours are similar . Pulmonary vasculature is not engorged . Airspace opacities within the left upper lobe appear progressed compared to the previous radiograph , with continued ill - defined opacities in both lung bases , more pronounced on the left , and not substantially changed in the interval . New ill - defined opacification is also seen within the perihilar region in the right upper lobe . Small left pleural effusion is present . No pneumothorax is present . There are mild degenerative changes noted in the thoracic spine .
    OUTPUT:
    
New right upper lobe ill - defined opacity and worsening left upper lobe airspace disease . Similar appearance of bibasilar ill - defined opacities . Findings may reflect superimposed infection or aspiration on a background of COP . Small left pleural effusion .