Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Two views were obtained of the chest . The lungs are somewhat low lung volume with left pleural effusion and basal atelectasis noted . Best seen on the lateral view is an extrapleural based opacity emerging from the chest wall , likely at the 2nd rib articulation with the sternum which is consistent with progression of the known chest wall metastatic lesion . Multiple bilateral pulmonary nodular opacities compatible with metastases are better seen on prior PET / CT . There is no pneumothorax . The heart is top normal size , with otherwise normal cardiac and mediastinal contours .
    OUTPUT:
    
1 . Increased opacity at left second costosternal articulation is consistent with progression of left chest wall metastasis . Muliple pulmonary nodules also again consistent with metastatic disease . 2 . Small to moderate left pleural effusion and atelectasis .