Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Small to moderate bilateral pleural effusions are new compared to the prior PET - CT of ___ and associated with adjacent bibasilar atelectasis . Cardiomediastinal contours are within normal limits . Within the lungs , a right middle lobe on 1 cm nodular opacity adjacent to the minor fissure has apparently grown since the prior CT PET study and is new compared to an older chest radiograph of ___ . Several additional small pulmonary nodules are also evident and not well characterized radiographically . A lobulated opacity in the retrosternal region could either be mediastinal or parenchymal in location . Mild compression deformities in the upper thoracic spine are new compared to ___ .
    OUTPUT:
    
New bilateral pleural effusions . Enlarging right middle lobe nodule and apparently new lobulated retrosternal opacity , concerning for metastatic disease .