Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the previous chest x-ray of ___ , a right pleural effusion has substantially increased it size . It is now moderate to large and apparently partially loculated laterally . Although only a small amount of pleural fluid was present on the prior chest x-ray , a more recent PET - CT of ___ , demonstrated a moderate amount of right pleural fluid . Direct comparison to the PET CT is difficult due to positional differences , but the effusion likely has increased in size further since that time . Known right mediastinal and hilar lymphadenopathy have been better characterized on the recent PET - CT . Worsening lung opacities in the right middle and right lower lobe are present . On the left , nonspecific areas of parenchymal scarring are present as well as scattered calcified pleural plaques , not substantially changed from the prior radiographs .
    OUTPUT:
    
Moderate - to - large , partially loculated right pleural effusion , with adjacent right middle and lower lobe opacities , which could reflect atelectasis or infectious consolidation . A post-obstructive process from known right hilar abnormality is an additional consideration . Findings have been communicated by telephone with Dr . ___ ___ at 9 : 15 a .m . on ___ .