Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest . Right greater than left apical scarring is again seen . There is a new small left pleural effusion . The lungs are clear consolidation or pneumothorax . The cardiac silhouette is enlarged which has progressed since prior . Hypertrophic changes are noted in the spine . No displaced rib fractures identified .
    OUTPUT:
    
New small left pleural effusion since ___ and interval enlargement of the cardiac silhouette .