Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Previously noted loculated right pleural effusion has increased in size . There is also now evidence of a small left pleural effusion . Numerous pulmonary nodules consistent with metastases are again noted . There is increased fullness of the right hilum consistent with known lymphadenopathy in the region .
    OUTPUT:
    
Interval increase in moderate right pleural effusion . There is also suggestion of a small left pleural effusion at this time . Known pulmonary metastases are again identified along with mediastinal lymphadenopathy .