Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is no pleural effusion or pneumothorax . A rounded opacity in the left upper lobe is again seen and corresponds to known malignancy and is better characterized on previous CT with precise measurements not being well delineated . Heart size is top normal and unchanged . The left hemidiaphragm is chronically elevated and left basilar atelectasis and scarring are again redemonstrated . There is no focal consolidation to suggest pneumonia . A VP shunt is seen coursing through the right hemithorax into the abdomen .
    OUTPUT:
    
No evidence of acute intrathoracic process .