Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no focal consolidation or effusion . There is a dominant nodule in the left perihilar region measuring approximately 2 .3 cm . Additional smaller nodules project over the bilateral lung apices . Given history of prior malignancy , underlying metastases would be of concern . Nonurgent chest CT is suggested to further evaluate . Cardiomediastinal silhouette is within normal limits . Left chest wall dual lead pacing device is seen as well as median sternotomy wires . Chronic deformity of the proximal left humerus suggests prior fracture .
    OUTPUT:
    
Bilateral pulmonary nodules concerning for metastatic disease . Nonurgent chest CT is suggested to further evaluate .