Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Overall appearance is similar to the prior examination with pleural thickening in the left lower lung field along with increased density and reticulation in the left lung base as well as similar moderate size left pleural effusion . Heart size is difficult to evaluate due to obscuration from surrounding consolidation . The left hilar contour is again prominent . The right lung remains essentially clear except for linear scarring in the base . There is no pneumothorax .
    OUTPUT:
    
Overall similar appearance to the prior examination with pleural thickening , left basilar opacification and left hilar fullness from known metastatic adenocarcinoma . Again increased density and reticulation in the left lung base could represent either pneumonia , lymphangitic tumor spread or atelectasis .