Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The small to moderate left pleural effusion is substantially smaller since earlier in the day and mediastinum has returned to the midline . There is no pneumothorax . A coarse interstitial abnormality , as seen on ___ preceded the development of this large pleural effusion , and is therefore not re-expansion edema , instead most likely disseminated carcinomatosis . Multiple lung nodules , particularly in the right middle lobe , the have been growing since ___ . Right supraclavicular central venous infusion port scans in the upper right atrium . Transvenous pacer defibrillator lead is continuous from the left axillary pacemaker to the floor of the right ventricle .
    OUTPUT:
    
Small moderate residual left pleural effusion , is primarily dependent , but not necessarily layering . Diffuse carcinomatosis left lung and multiple pulmonary metastases predominantly in the right lung unchanged . No pneumothorax .