Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral images of the chest . Multiple opacities are again seen in the bilateral lungs , consistent with known metastatic disease and grossly stable . No definite new opacity is seen to suggest pneumonia , however can not exclude an infectious process in the presence of the multiple lung opacities . A loculated right pleural effusion is seen , similar prior exam . Cardiomediastinal silhouette is unchanged from prior exam .
    OUTPUT:
    
Multiple pulmonary opacities , consistent with known metastatic disease , without significant interval change . No definite new opacity , but can not entirely exclude pneumonia in the presence of the multiple lung opacities .