Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a maoderate to large right - sided pleural effusion , similar to exam from earlier the same day but enlarged since ___ . Bilateral pulmonary nodules are again seen , largest in the left lower lobe medially measuring approximately 3 cm . There is no left - sided pleural effusion . Abnormal mediastinal contour particularly on the right is compatible with known mediastinal adenopathy . No acute osseous abnormalities identified .
    OUTPUT:
    
Moderate to large right - sided pleural effusion has enlarged since ___ .