FINDINGS:
Cardiomediastinal contours are stable in appearance.  Widespread
 bilateral pulmonary metastases are again demonstrated.  Apparent worsening
 opacity in the left retrocardiac region could potentially be due to a
 developing pneumonia, given clinical suspicion for this entity.  Consider
 standard PA and lateral chest radiographs for more complete evaluation of this
 region when the patient's condition allows.  Note is also made of a small left
 pleural effusion.