Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are unchanged . The lungs are hyperinflated . There is no pneumothorax . Loculated right pleural effusion has increased . Small left effusion is stable . There are no evident thickening lung abnormality . Degenerative changes in the thoracic spine are again noted
    OUTPUT:
    
Increase in size in loculated right pleural effusion