Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the chest radiographs obtained ___ , no significant changes are appreciated . Extensive , bilateral , nodular opacities are grossly unchanged and compatible with extensive , known metastatic disease . Small , right pleural effusion is unchanged . Extensive sclerosis of the vertebral bodies compatible with bony metastasis is also grossly unchanged without evidence of fracture . No obvious consolidations compatible with pneumonia . Heart size is normal without pulmonary edema . Elevation of the left hemidiaphragm and gaseous distention of the adjacent colon are unchanged . Port - A - Cath tip projects over the right atrium .
    OUTPUT:
    
Extensive intrathoracic metastatic disease as described above is grossly unchanged . No superimposed acute cardiopulmonary abnormalities .