Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison to prior study from ___ , there has been in increase in both size and number of multiple bilateral pulmonary nodules . While the right upper lobe opacity with volume loss has remained stable , there is a new , confluent , consolidative left perihilar opacity . This new opacity is centered in the lingula but also involves the left upper lobe . Again visualized is a collapsed T11 vertebral body as noted previously . However , multiple known metastatic lesions throughout osseous structures are not clearly visualized on today 's study .
    OUTPUT:
    
1 . There is a new , confluent , consolidative left perihilar opacity centered in the lingula with involvement of the left upper lobe . This opacity is most consistent with a lingular pneumonia . 2 . Multiple small bilateral pulmonary nodules have increased in both size and number and are suspicious for worsening of metastatic lung disease . 3 . Right upper lobe atelectasis appear stable . These findings were discussed by Dr . ___ with Dr . ___ via telephone at 2 : 40 pm on ___ .