FINDINGS:
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.

IMPRESSION:
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.