Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to ___ portable chest radiograph , there are no significant changes noted . The cardiomediastinal contour and diffuse metastatic lung nodules are unchanged from prior study . There is a residual small right pleural effusion unchanged from prior study . No left pleural effusion seen . Mild right - sided subcutaneous emphysema at the site of chest tube entry is unchanged from prior study . Bilateral pleural drains are in stable position . Pacer wires follow their expected courses to the right atrium and right ventricle from the left pectoral generator .
    OUTPUT:
    
1 . No change in size of small right pleural effusion since ___ : 23 . 2 . All support lines are in stable position . 3 . Extensive lung metastases .