Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There are numerous bilateral pulmonary nodules throughout the lungs with most extensive disease burden in the lower lobes . Cardiomediastinal silhouette is within normal limits given the relatively low lung volumes . No acute osseous abnormalities identified .
    OUTPUT:
    
Innumerable bilateral pulmonary nodules worrisome for metastatic disease in light of history a squamous cell carcinoma and previously noted pulmonary nodules in ___ . Superimposed acute process such as infection would be difficult to exclude .