Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a persistent large left - sided pleural effusion although with overall volume loss and mild leftward shift of mediastinal and cardiac structures . Overall quantity of fluid is probably fairly similar and , given overall volume loss , extensive atelectasis of the left lower lobe and lingula is suspected . Right lung remains clear . There is no pleural effusion . Heart is probably enlarged but its contours are partly obscured . Aortic arch is calcified .
    OUTPUT:
    
Similar large left - sided pleural effusion with extensive atelectasis including overall volume loss in the left hemithorax .