Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged . The chest is hyperinflated . There is similar mild volume loss in the left upper chest with widespread opacification and pleural thickening . There is no definitive change in this area since the prior study , although the upper part of a left suprahilar density appears perhaps somewhat more dense . More clear change is new destruction of the right posterior fifth rib with overlying opacity worrisome for metastatic disease .
    OUTPUT:
    
1 . New destruction of the right sixth rib with overlying opacity worrisome for a metastasis . 2 . Equivocal increase in density of left upper lung opacity , although perhaps an artifact of slightly different orientation .