Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size can not be definitively assessed due to adjacent pleural effusion , but is likely unchanged . Compared to ___ , no significant change in moderate right pleural effusion . There is adjacent right compressive atelectasis . No left pleural effusion . No pneumothorax . No acute osseous abnormalities .
    OUTPUT:
    
Moderate in size pleural effusion which appears similar to the prior with probable compressive right lower and middle lobe atelectasis . Difficult to exclude an underlying malignant process and follow - up to resolution is advised .