Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The number and size of bilateral pulmonary nodules have increased since ___ and are better seen on CT chest exam from the same day . No pleural effusion or pneumothorax . Stable appearance of the cardiomediastinal silhouette .
    OUTPUT:
    
Interval increase in the number and size of bilateral pulmonary nodules , presumed metastases .