Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Numerous nodular opacities compatible the patient 's metastatic disease are again appreciated . In addition , there is worsening pulmonary edema as well as a worsening right lower lobe infiltrate which could represent pneumonia in the correct clinical setting . A right pleural effusion is also increased in size .
    OUTPUT:
    
Worsening combination of pleural effusion , pulmonary edema and possibly pneumonia particularly in the right lower lobe .