FINDINGS:
Mild-to-moderate edema is new.  The opacity in the right lower lobe with
 silhouetting of the right hemidiaphragm costophrenic angle is concerning for
 new airspace opacity such as infection and/or edema.  Increased opacity in the
 left lower lobe may reflect a combination of edema, concurrent infection, and
 atelectasis.  Persistent elevation of the left hemidiaphragm is unchanged.
 Bilateral pleural effusions hernia.  Left lower lung pleural calcifications
 are unchanged since at least .  Sub- 4 mm opacities projecting over the
 left upper lobe are unchanged since at least, likely granulomas.

IMPRESSION:
Bilateral increased lower lobe opacities and pleural effusions are consistent
 with volume overload, however concurrent multifocal pneumonia cannot be
 excluded.  Given history of hemoptysis and increased opacity in the left lower
 lobe, recommend non emergent CT of to exclude an underlying mass.
 
 RECOMMENDATION(S):  Non-emergent chest CT to exclude an underlying mass.