Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest were obtained . Midline sternotomy wires and mediastinal clips are again noted . The lungs appear clear bilaterally without definite signs of pneumonia or CHF . The patient is known to have multiple pulmonary metastases which are not well seen . A lesion in the left lower lobe projects over the posterior margin of the heart on the lateral view . A nodular opacity is again noted in the left upper lobe . No pleural effusion or pneumothorax . Heart size is stable . Mediastinal contour is also stable . Bony structures appear intact .
    OUTPUT:
    
Known lung metastases are again noted though better assessed on prior CT . No definite signs of superimposed acute process .