Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . There is a large left pleural effusion which appears increased from recent prior CT exam . Patient is known to have multiple pulmonary metastatic lesions which are better assessed on the recent CT . Heart size can not be assessed . Mild edema difficult to exclude . Bony structures appear intact .
    OUTPUT:
    
Increased left pleural effusion . Known metastatic disease . Mild edema difficult to exclude .