Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac and mediastinal silhouettes are stable . Again seen are numerous bilateral nodular opacities consistent with metastatic disease . Projecting over the medial left mid to lower lung , there is a more rounded area of opacity measuring approximately 5 .0 x 4 .2 cm , not clearly delineated on the most recent prior chest radiograph , although more similar appearance to ___ . No large pleural effusion is seen . There is no pneumothorax . No overt pulmonary edema is seen .
    OUTPUT:
    
Extensive bilateral pulmonary metastases