Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right internal jugular catheter terminates at the cavoatrial junction . Heart is enlarged , and diffuse mediastinal and hilar widening are present , likely due to a combination of distended vessels and lymph node enlargement . Pulmonary nodules and masses have rapidly grown since the prior PET - CT with a dominant mass in the left lower lobe now measuring approximately 9 cm in diameter . New confluent opacities in the right perihilar and basilar region probably represent a combination of airspace disease and solid masses . . Note is also made of small bilateral pleural effusions which are apparently new from the prior PET - CT .
    OUTPUT:
    
Marked progression have intrathoracic metastatic disease with likely superimposed acute process such as asymmetrical edema or infectious pneumonia . Considering the complexity of findings and known history of sarcoma , further evaluation with chest CT MAY BE HELPFUL .