Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear stable . A fiducial marker in the right lung as well as clips along the medial right lung apex appear unchanged . Patchy opacities in the left mid lung suggest unchanged scarring . Upper lungs are lucent suggesting emphysema . Three nodules in the posterior left lower lobe have increased in size . The chest is hyperinflated .
    OUTPUT:
    
Increased nodules in the left lower lobe suggesting metastatic malignancy . No evidence of acute cardiomegaly .