Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right chest wall port is again seen . The appearance the lungs has not significantly changed . Moderate to large left pleural effusion is noted . There is also small to moderate right pleural effusion . Multiple bilateral pulmonary nodules are partially visualized . Superiorly the lungs are clear . Cardiac silhouette can not be accurately assessed given silhouetting for opacity at the left lung base .
    OUTPUT:
    
No significant interval change . Moderate to large left and small to moderate right pleural effusions . Bilateral pulmonary metastases .