Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP and lateral views of the chest . Again seen are bilateral nodular opacities in the lungs compatible with patient 's known metastatic disease . New from prior chest x-ray but seen on interval CT scan is a left - sided pleural effusion with associated atelectasis . Increased pleural based opacity on the left laterally adjacent to the lung base is likely progression of metastatic disease as well . Trace right effusion is also seen . There is no definite superimposed acute consolidation although one would be difficult to exclude and definite acute osseous abnormality detected .
    OUTPUT:
    
Left - sided pleural effusion , as seen on prior chest CT , with additional increased left basilar opacity potentially due to progression of metastatic disease although superimposed acute process would be difficult to exclude .