Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to ___ , heart size is normal and unchanged . The aorta is calcified , indicating atherosclerosis . Lungs are hyperinflated and there is a background of emphysema . The right - sided PleurX catheter is poorly visualized but appears unchanged in position . Slight increase in right pleural effusion . Again seen are multiple lesions throughout the chest representing metastatic disease , grossly unchanged . Again seen are fiducial markers in medial aspect of the right upper lobe . There is persistent blunting of the left costophrenic sulcus , likely representing a small pleural effusion or pleural thickening . No pneumothorax . No acute osseous abnormality .
    OUTPUT:
    
Overall , slight interval increase in small right pleural effusion compared to ___ . The right - sided PleurX catheter is poorly visualized but appears unchanged in position .