Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided Port - A - Cath tip terminates in the proximal right atrium . Mild cardiomegaly is re - demonstrated . Mediastinal and hilar contours are grossly similar without pulmonary vascular congestion . Emphysema is again noted within the upper lobes . New lobulated dense opacity with peripheral haziness medially is seen within the lateral aspect of the right lower hemi thorax , and appears pleural based . Nodular opacities within both lungs are re - demonstrated , grossly unchanged compatible with known metastatic disease . Small bilateral pleural effusions are unchanged . No pneumothorax is present . Clips are noted overlying the epigastric region . There are no acute osseous abnormalities detected .
    OUTPUT:
    
1 . Interval development of lobulated opacity in the lateral aspect of the right lower hemi thorax which is pleural based , and could be a loculated pleural effusion but hemothorax is not excluded . Further assessment with chest CT is recommended . 2 . Small bilateral pleural effusions and multiple nodules in both lungs compatible with metastatic disease are grossly unchanged .