Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low . Cardiac silhouette is normal in size allowing for this factor , but demonstrates left ventricular configuration . Aorta is tortuous and calcified . Pulmonary vascularity is normal . Bibasilar atelectasis has developed , involving the right lung base greater than the left . There are also new small bilateral pleural effusions . A 5 cm diameter , elliptical extraparenchymal opacity ( pleural or extrapleural ) in the upper left hemithorax is new since ___ , but is in retrospect similar to preoperative chest radiograph of ___ . On today 's study , there is a question of adjacent rib destruction at the third left anterolateral rib level associated with this opacity .
    OUTPUT:
    
5 cm elliptical opacity in the left upper hemithorax , with apparent adjacent focal rib destruction . As this finding is new since ___ , it is concerning for a possible focus of metastatic disease in this patient with history of primary renal malignancy . CT may be helpful for further characterization . Dr . ___ has been notified of this finding by telephone at 8 :30 a .m . on ___ at the time of discovery .