Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart size is normal . The mediastinal and hilar contours are unremarkable . Extensive emphysematous changes are again seen , most pronounced within the upper lobes bilaterally . Deformity of the left upper and lateral hemithorax with increased sclerosis of the left anterolateral ribs is a result of patient 's known large chest wall mass , better demonstrated on the prior chest CT . Trace left pleural effusion is again seen . No new areas of focal consolidation , right pleural effusion or pneumothorax is demonstrated . There is no pulmonary vascular congestion .
    OUTPUT:
    
Deformity of the left upper lateral hemithorax with increased sclerosis of the ribs is compatible with known large chest wall mass , better delineated on the previous chest CT . Small left pleural effusion . No new areas of focal consolidation identified .