Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Chest , upright AP and lateral . The lung volumes are low . There are bilateral perihilar opacities as well as multiple new pulmonary nodules in both lungs , concerning for worsening metastatic disease . There is atelectasis at the lower lobes and likely a small left pleural effusion . There is likely a small left pleural effusion . No pneumothorax is seen . Given the limitations of technique , the heart size is likely normal .
    OUTPUT:
    
1 . Interval development of several new pulmonary nodules consistent with progression of metastatic disease . 2 . Mild pulmonary edema and small left pleural effusion .