Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is again mild - to - moderately enlarged . There is new confluent opacification in the left upper lobe , particularly near the apex with lesser involvement elsewhere . To a lesser degree , there is also new right apical opacification . A right lower lung opacity is similar to improved , however . The lungs are hyperinflated . There is no pleural effusion or pneumothorax . Bony structures are unremarkable .
    OUTPUT:
    
Much more extensive lung opacification than seen on the prior study including confluent left apical opacification with a distribution that is not typical for pulmonary edema . An infectious process could be considered , but the process is widespread but heterogenous , with a strikingly peripheral distribution in the left upper lobe which could be seen with an eosinophilic pneumonia , which has been described as a manifestation of cocaine - related lung disease . A coinciding component of pulmonary edema is also possible .