Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive pleural based metastatic lesions are again noted within the right hemi thorax , increased in size compared to the previous radiograph ___ . Additionally , there is a is small right pleural effusion , perhaps similar in size compared to the previous radiograph . Worsening opacification within the right lung base may reflect increased atelectasis , but infection is not excluded . The cardiac and mediastinal contours otherwise appear unchanged . Left lung remains clear without new focal consolidation . There is no left - sided pleural effusion . No pneumothorax is present . The pulmonary vasculature does not appear engorged .
    OUTPUT:
    
Extensive pleural based metastases within the right hemi thorax , increased in size compared to the previous radiograph . Small right pleural effusion appears somewhat similar compared to the prior radiograph . Worsening opacification in the right lung base may reflect increased atelectasis though infection can not be excluded .