Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Mild to moderate enlargement of the cardiac silhouette is re - demonstrated . The mediastinal and hilar contours are unchanged with chronic elevation of the left hemidiaphragm . Hilar contours are normal , and pulmonary vasculature is not engorged . Linear opacities at the lung bases likely reflect atelectasis and / or scarring without focal consolidation . Hyperinflation of the lungs persists , suggestive of COPD . Blunting of the left hemidiaphragm posteriorly suggests a small left pleural effusion , new in the interval . There are moderate degenerative changes noted throughout the thoracic spine .
    OUTPUT:
    
Interval development of small left pleural effusion . Bibasilar atelectasis and / or scarring .