FINDINGS:
There is a moderate pleural effusion on the left.  It is difficult
 to compare regarding any change in size because of differences in orientation
 since the prior examination.  Patchy nodular and reticular abnormalities
 suggest metastatic disease.  In addition there is a confluent new opacity in
 the lingula, possibly superimposed pneumonia versus patchy but substantial
 atelectasis.  In attempting to compare with the scout view from the recent
 prior CT there is also apparently increased patchy right lower lung
 opacification with a similar differential diagnosis.

IMPRESSION:
Similar to increased prominence of widespread interstitial and
 nodular opacities, probably representing a metastatic disease.  New patchy
 basilar opacities, particularly in the left lower lung for which pneumonia
 could be considered in the appropriate clinical setting versus atelectasis. 
 Persistent moderate left-sided pleural effusion which is difficult to compare
 regarding any change in size because of differences in technique.