Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal and hilar contours are unchanged , with mild calcification of the aortic knob . Hilar contours are stable . Pulmonary vascularity is not engorged . Innumerable pulmonary nodules are seen in both lungs compatible with metastatic disease . Small right pleural effusion appears increased in size compared to the prior exam . There is associated right basilar opacity which may reflect compressive atelectasis . Streaky left basilar opacity also may reflect atelectasis . There is no pneumothorax . Mild degenerative changes are seen in the thoracic spine . A lytic lucency within the left proximal humerus measuring 9 mm is not fully assessed on this study .
    OUTPUT:
    
1 . Increased size of small right pleural effusion . Bibasilar airspace opacities may reflect atelectasis though infection can not be excluded . 2 . Bilateral pulmonary metastases , relatively unchanged compared to the prior exam . 3 . 9 mm lytic lesion in the left humeral head , incompletely assessed , but concerning for metastasis .