Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate pleural effusion on the left . It is difficult to compare regarding any change in size because of differences in orientation since the prior examination . Patchy nodular and reticular abnormalities suggest metastatic disease . In addition there is a confluent new opacity in the lingula , possibly superimposed pneumonia versus patchy but substantial atelectasis . In attempting to compare with the scout view from the recent prior CT there is also apparently increased patchy right lower lung opacification with a similar differential diagnosis .
    OUTPUT:
    
Similar to increased prominence of widespread interstitial and nodular opacities , probably representing a metastatic disease . New patchy basilar opacities , particularly in the left lower lung for which pneumonia could be considered in the appropriate clinical setting versus atelectasis . Persistent moderate left - sided pleural effusion which is difficult to compare regarding any change in size because of differences in technique .