Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is again noted herniation of the liver a Morgagni hernia . Spinal stabilization hardware is noted in the lower C - spine . There is subtle reticular opacity in the left lower lobe which could represent very early pneumonia in the right clinical setting . No large pleural effusion is seen . Heart size appears essentially stable , though the right heart border is obscured . Mediastinal contour is unchanged . Bony structures are intact .
    OUTPUT:
    
There is again substantial herniation of the liver a Morgagni hernia on the right . No pleural effusion .