Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low , causing exaggeration of the heart size and accentuation of the pulmonary vasculature . A heterogeneous opacity overlying the lower thoracic spine on the lateral radiograph could be atelectasis , although pneumonia can not be excluded . The lungs are otherwise clear . Heart size is normal . The descending thoracic aorta is tortuous , as before . The mediastinal contours are otherwise normal . There is a small right pleural effusion . No pneumothorax is seen . Elevation of the right hemidiaphragm is chronic . Old right posterior rib fractures are again seen .
    OUTPUT:
    
1 . Heterogeneous opacity overlying the lower thoracic spine on the lateral radiograph could be atelectasis , although pneumonia can not be excluded in the appropriate setting . 2 . Small right pleural effusion .