Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A moderate size left pleural effusion is not substantially changed in the interval with associated left basilar opacity , likely atelectasis . Fluid is also noted overlying the left apex as well as loculated posteriorly along the left base . Cardiac and mediastinal contours appear unchanged . Pulmonary vasculature is not engorged . The right lung is clear . Multiple pulmonary nodules are seen in both lungs , increased in size and number compared to the previous exam , with the largest noted in the left mid lung field measuring up to 2 cm . No large pneumothorax is present . Elevation of the left high hemidiaphragm is re - demonstrated and attributable to multiple extensive hepatic masses . No acute osseous abnormality is identified .
    OUTPUT:
    
1 . Chronic elevation of the left hemidiaphragm with similar - appearing moderate left pleural effusion , a component which is loculated at the posterior base , and left basilar opacity likely atelectasis . 2 . Increased size and number of bilateral pulmonary nodules concerning for progression of metastatic disease .