Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is mildly enlarged but unchanged . The aortic knob is calcified . Enlargement of the hila bilaterally is compatible with pulmonary arterial hypertension as well as underlying lymphadenopathy . The mediastinal contours are unchanged . Scattered ill - defined nodular opacities are relatively similar compared to the prior exam , compatible with known metastatic lesions . There is mild pulmonary vascular engorgement . No pleural effusion , new focal consolidation or pneumothorax is present . There are no acute osseous abnormalities .
    OUTPUT:
    
Scattered ill - defined nodular opacities compatible with known metastatic disease , relatively unchanged compared to the prior study . Enlargement of the hila bilaterally , likely reflective of pulmonary arterial hypertension and underlying lymphadenopathy . Mild pulmonary vascular engorgement .