Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Bilateral pulmonary nodules are again compatible with patient 's known metastatic disease . There is a right - sided pleural effusion as seen on prior CT from ___ which may have slightly enlarged . Adjacent right basilar opacity is also noted which could be due to atelectasis although superimposed infection would certainly be possible . Appearance of the left lung has not changed noting the pulmonary nodules and retrocardiac mass . Right hilar enlargement is better seen on prior CT . Large hiatal hernia is again noted . Surgical clips seen in the lower neck .
    OUTPUT:
    
Right - sided pleural effusion , perhaps slightly larger from ___ compared to prior chest CT . Adjacent opacity could be secondary to atelectasis although superimposed infection can not be excluded . Otherwise no change in the appearance of the bilateral pulmonary nodules and masses .