Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette size is difficult to determine given the presence of a moderate left pleural effusion and elevation of the left hemidiaphragm , findings which are unchanged compared to the previous exam . Mediastinal contour is similar with tortuosity of the thoracic aorta again demonstrated . Pulmonary vasculature is not engorged , and the hilar contours are unchanged . Left basilar atelectasis is re - demonstrated . A small right pleural effusion is also unchanged . No pneumothorax is identified . Known metastatic lesions within the chest are re - demonstrated but better visualized on the previous CT . Multiple clips are seen in the left axillary region and chest wall . Calcified pleural plaques are re - demonstrated bilaterally .
    OUTPUT:
    
Similar moderate left pleural effusion with left basilar atelectasis . Trace right pleural effusion , unchanged . Known pulmonary metastases grossly unchanged , but better assessed on previous CT .