Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal radiograph of the chest demonstrates a previously seen small left pleural effusion with two pleural tubes in unchanged position compared to the prior study . The right lung opacification is also again seen , and likely represents a combination of atelectasis with a small effusion . There is no pneumothorax or significant pulmonary edema . The heart size is unchanged since the prior study . Apical pleural thickening is also noted .
    OUTPUT:
    
Small left pleural effusion is again seen , any significant change is not identified since the prior study .