Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient 's condition required examination in sitting upright position using AP frontal and left lateral views . Available for comparison is the next preceding similar study of ___ . The patient has a known adenocarcinoma of the lung with brain metastases . Comparison is made during the present image evaluation . On the frontal view , the densities surrounding the left - sided lung have increased and aeration of the remaining left lung is diminished resulting in a further mediastinal shift towards the left . In the right hemithorax , the already earlier visible multiple nodular densities indicative of secondary metastases have increased . There is now also mild blunting of the right - sided lateral pleural sinus which was not present on the previous examination . No pneumothorax can be identified on either side . The position of the right - sided Port - A - Cath system advanced via the right internal jugular approach remains unchanged . Heart size has not increased and there is no evidence of pulmonary vascular congestion .
    OUTPUT:
    
Progression of left - sided lung masses , decreased aeration in left hemithorax , On the right side advanced evidence of secondary metastasis in lung , no pneumothorax , no massive pleural effusions that would deserve additional drainage . A left - sided basal small caliber drainage tube is noted to be unchanged but poorly visible because of overlying pleural and parenchymal abnormalities .