Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been little change in comparison to prior radiograph from ___ . Again visualized is opacification of the right lung base due to the presence of pleural and pulmonary metastases as well as atelectasis . Right - sided pleural effusion is again present , likely slightly larger in size compared to the prior study given increased haziness in the right upper lung field . Determination of the exact size of the effusion is difficult given the presence of the right basilar necrotic metastases , and the effusion has multiple loculated components as seen on the prior CT . Multiple nodular opacities are visualized in the right upper lobe and appear enlarged in comparison to prior study likely representing pleural and parenchymal metastases . The left lung remains clear . Heart size remains normal . Mild - to - moderate dextroscoliosis of the mid thoracic spine remains unchanged . Previously noted left PICC has been removed .
    OUTPUT:
    
Right - sided pleural effusion is likley slightly larger in size , which appears loculated laterally and apically . No significant interval change in opacification of the right lung base due to the presence of pleural and pulmonary metastases as well as atelectasis . Nodular opacities in the right upper lobe appear larger compared to prior , likely representing metastases .