Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is normal . Chain sutures are again seen within the right upper lobe . Extensive metastatic disease is again noted with widening of the superior mediastinum , right hilar lymphadenopathy , extensive nodular deposits and irregular thickening along the pleura bilaterally , and innumerable bilateral pulmonary nodules . A right upper lobe dominant mass appears unchanged . The lungs remain hyperinflated compatible with COPD . A trace left pleural effusion is likely present . Compared to the most recent previous radiograph , there is increased opacification within the right upper lobe which could reflect infection in the appropriate clinical setting . No large pleural effusion or pneumothorax is present . Known osseous metastatic disease is better visualized on the recent chest CT .
    OUTPUT:
    
Increased opacification within the right upper lobe may reflect infection in the correct clinical setting . Extensive metastatic disease throughout the thorax is otherwise grossly unchanged .