Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been no significant change from prior study with multiple bilateral pulmonary metastatic lesions including a left upper lobe lesion measuring approximately 3 .4 cm . Perihilar opacities are unchanged and are more fully characterized on the prior CT with no significant change from prior . No large effusion or pneumothorax is seen . The heart size is unchanged . Bony structures are intact .
    OUTPUT:
    
Diffuse metastatic disease with overall pattern unchanged from recent prior exam . No evidence of an acute superimposed pneumonia .