Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in sitting semi-upright position . Comparison is made with the next preceding similar study of ___ . General findings of poor inspirational effort in this very adipous patient unchanged . Heart size has not increased and there is no pulmonary congestion identified . The left - sided chest tube remains in unchanged appropriate position . It is noted that the amount of pleural effusion has increased , now presenting in the form of a 2 to 3 cm wide density in the left axillary region .
    OUTPUT:
    
No evidence of increasing pneumothorax but increasing pleural effusion is noted .