Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest . Tracheostomy tube is in unchanged expected position . Numerous rounded opacities are noted in both lungs which are increased in size and number compared to the prior study consistent with patient 's known metastatic disease no pleural effusion or pneumothorax . Normal heart size . Stable aortic tortuosity . No definite pneumonia .
    OUTPUT:
    
Increasing size and number of numerous pulmonary metastases . No radio - opaque foreign body . If persistent sensation , a barium swallow could be used to evaluate for foreign body .