Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Large right middle lobe and lower lobe pleural effusion with presumed underlying atelectasis is new compared to prior . The size of the pleural effusion is concerning . CT of the chest can further characterize the underlying etiology . Minimal interstitial edema is present in the remaining lungs . The lungs are otherwise clear . Mild cardiomegaly is unchanged . The mediastinum is unchanged . No pneumothorax . Left anterior eighth to tenth rib fractures . The pacemaker leads and sternotomy wires are in unchanged position .
    OUTPUT:
    
1 . Large pleural effusion in the right middle and lower lobe of unknown etiology . 2 . Left ___ to 10th rib fractures .