Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size is mildly enlarged but unchanged . The mediastinal and hilar contours similar with fullness of the right hilum and paratracheal stripe compatible with known lymphadenopathy . Innumerable nodules are demonstrated throughout the lungs compatible with metastatic disease . No focal consolidation , pulmonary edema , or pneumothorax is seen . A small left pleural effusion is likely present . No acute osseous abnormalities are seen . Known osseous metastases seen on prior CT are not well assessed on the current exam .
    OUTPUT:
    
Widespread metastatic disease , not substantially changed from the recent CT exam . Small left pleural effusion . No focal consolidation concerning for pneumonia .