Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube terminates approximately 3 cm from the carina . Heart size is normal . The aorta is tortuous and diffusely calcified . Heterogeneous opacities are again seen within the right upper and mid lung fields , findings which appear worse in the interval , and likely reflect a combination of known metastases and worsening infection and / or aspiration . Small right pleural effusion is unchanged and there is no pneumothorax . Patchy opacity in the left lung base also reflects known metastases with probable superimposed infection or aspiration . Metallic stent is seen in the region of the common bile duct with multiple clips noted in the right upper quadrant . Extensive vascular calcifications are noted within the left upper abdomen . Marked degenerative changes of both glenohumeral joints are seen with right anterior shoulder subluxation and 2 soft tissue anchors projecting over the right humeral head .
    OUTPUT:
    
1 . Endotracheal tube in standard position . 2 . Heterogeneous opacities in the right upper and mid lung fields as well as patchy left basilar opacity appear worse in the interval and likely reflect a combination of known metastatic disease with worsening infection or aspiration . Unchanged small right pleural effusion .