Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The cardiac , mediastinal and hilar contours are normal . Pulmonary vascularity is not engorged . The lungs remain hyperinflated . No focal consolidation , pleural effusion or pneumothorax is identified . Scattered ill - defined focal opacities within both lungs are new or worse when compared to the prior exams . For instance an ill - defined nodular opacity projecting within the right lung base measures approximately 1 .9 centimeters . These are concerning for progression of pulmonary metastases . Diffuse osseous sclerotic lesions have also progressed when compared to the prior exam , and are seen involving the ribs bilaterally as well as the thoracic spine .
    OUTPUT:
    
Progression of osseous sclerotic metastases and likely of pulmonary metastases . Otherwise no acute cardiopulmonary abnormality .