Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a prominent left cardiac fat pad as before . A round lingular nodule is again suspicious for malignancy . There is no definite pleural effusion or pneumothorax , although a slight new blunting of posterior costophrenic sulci is noted , possibly due to minor atelectasis or trace pleural effusion on the left side .
    OUTPUT:
    
Possible trace left - sided pleural effusion , without other significant change , including a persistent suspicious lingular lung nodule .