Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours appear unchanged including right perihilar masses . The contours of the mid to lower trachea are indistinct on the right corresponding to known tracheal narrowing associated with a dominant mass involving the upper mediastinum . There is a more distinct round mass than before visualized in the right lower lung , possibly reflecting an increase in metastatic disease versus loculated pleural effusion since the prior radiographs , although necessarily changed when differences in technique are considered . There is persistent mild elevation of the right hemidiaphragm . Patchy right basilar opacity suggests atelectasis in addition to extensive pleural - based metastatic disease in the right lower hemithorax . The left lung remains clear .
    OUTPUT:
    
No definite change in metastatic masses in the right hemithorax . Tracheal narrowing by a dominant mass , although present before and not necessarily changed , in the setting of known recent growth of metastases .