Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again noted is a moderate - sized left pleural effusion , unchanged from prior , with chronic loculated components . There is adjacent atelectasis at the left lung base . There is no focal airspace consolidation to suggest pneumonia . There is no pneumothorax . The heart size is large but unchanged . The mediastinal silhouette is unremarkable . A right side pacemaker is noted with a single wire terminating in the right ventricle . A left side hemodialysis catheter is noted to terminate in the right atrium . Sternotomy wires are noted .
    OUTPUT:
    
Unchanged moderate left pleural effusion .