Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a very large left - sided pleural effusion with complete collapse of the left lower lobe and the lingula . This has increased significantly in size when compared to the prior abdominal radiograph . The right lung appears grossly clear . No right - sided pleural effusion seen . A dense nodular opacity at the left apex is likely due to multiple overlapping bony structures .
    OUTPUT:
    
Significant interval increase in the left - sided pleural effusion with near complete collapse of the left lung sparing only in the apical portion of the left upper lobe .