Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac , mediastinal and hilar contours are unchanged , with the heart size within normal limits . Ill - defined pleural and parenchymal nodular opacities are seen diffusely throughout the lungs bilaterally with continued diffuse increased interstitial opacities worrisome for lymphangitic spread of tumor . Moderate left and small right pleural effusions are unchanged . Streaky opacities in the lung bases likely reflect areas of compressive atelectasis . No pneumothorax is demonstrated . Partially imaged is a common bile duct stent .
    OUTPUT:
    
No substantial interval change from the prior radiograph . Continued moderate size left and small right pleural effusions with bibasilar opacities , likely atelectasis , but infection can not be completely excluded . Diffuse pulmonary and pleural nodules compatible with metastases as well as lymphangitic carcinomatosis as seen previously .