Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large half left pleural effusion layering posteriorly that is increased in size compared to prior there is mediastinal shift to the left suggesting volume loss / collapse of the left lower lung . Compared to the prior study the effusion and associated volume loss on the left are increased the right lung is relatively clear the appearance of the right central line is unchanged
    OUTPUT:
    
Worsened appearance to the left lung