Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Bilateral chest tubes are again seen in changed position as compared to radiograph from ___ . The cardiomediastinal silhouettes are grossly unchanged . Again seen are diffuse reticulonodular airspace opacities consistent with widespread metastatic disease with more confluent areas in the right mid and lower lung . There is improved aeration of the left lower lobe , with improved visualization of the left hemidiaphragm and retrocardiac areas . Better appreciated on this study is a localized right anterior hydro-pneumothorax , with air - fluid level best seen on lateral view in the retrosternal region . Moderate size of right effusion is unchanged since prior radiograph . There is also an unchanged small left pleural effusion . There is no left - sided pneumothorax .
    OUTPUT:
    
Right anterior loculated hydro-pneumothorax ; overall unchanged size of right pleural effusion . Stable small left pleural effusion but interval improvement in left lower lobe opacification .