FINDINGS:
Again seen are multifocal patchy airspace opacities in a similar distribution
 to the prior study, predominately in the left base.  The appearances are
 consistent with a multifocal pneumonia.  Some of the nodular opacities may
 represent metastases.  Persistent left basilar atelectasis and small bilateral
 pleural effusions.  No pneumothorax seen.

IMPRESSION:
No significant interval change when compared to the prior study.  Findings
 consistent with a multifocal pneumonia, metastatic disease cannot be excluded.