Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding similar chest examination ___ ___ . There is status post sternotomy and bypass surgery as before . Observed that a rounded needle fragment is again observed just on top of the sternotomy sutures seen on frontal and lateral view . The patient 's heart size remains completely unchanged . No pulmonary congestive pattern is identified . There is now evidence of a small amount of pleural effusion blunting the right lateral pleural sinus and extending into a small amount of pleural effusion accumulating in the dependent posterior pleural sinus . The amount is small . No pneumothorax has developed .
    OUTPUT:
    
Considering the history of recent chemoembolization in the liver , the pleural effusion may be a reaction to this event . Amount is small . Suggest a followup examination in a week unless patient shows increased symptoms .