Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A single portable frontal chest radiograph was obtained . Lung volumes are low . A large right paratracheal mass is grossly unchanged since ___ . A mass in the right major fissure is similar . The moderate right pleural effusion is similar . Cardiomegaly is unchanged . There is no pneumoperitoneum .
    OUTPUT:
    
No pneumoperitoneum . Extensive metastatic myeloma is grossly similar to priors .