Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild cardiomegaly has improved since the prior study . The hilar and mediastinal contours are normal . The lung volumes are low . Bilateral moderate - sized pleural effusions , with compressive atelectasis of the lung bases are noted . A left chest wall AICD device is seen with leads in the expected position . There is no pneumothorax . Diffuse sclerosis of the ribs and thoracic spine consistent with diffuse metastatic disease , has progressed significantly since the earlier study of ___ .
    OUTPUT:
    
2 . Bilateral cardiomegaly and bilateral pleural effusions with bibasilar atelectasis . 3 . Extensive osseous metastatic disease , worse since earlier study of ___ .