Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest are provided . Evaluation is limited due to patient 's body habitus . Lung volumes are low . Left costophrenic angle is obscured , suggestive of small left pleural effusion and / or atelectasis , unchanged . The cardiomediastinal silhouette appears widened , unchanged , which is likely accentuated by AP technique and low lung volumes . No pneumothorax . Interval removal of the nasoenteric tube . Fixation hardware in the lower lumbar spine is noted . The left shoulder joint prosthesis is in place .
    OUTPUT:
    
In comparison with ___ exam , there is no significant interval change in obscuration of left costophrenic angle , which likely represents small pleural effusion and / or atelectasis .