Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views were obtained with patient in upright position . The heart size can not be assessed as sizable left - sided pleural effusion conceals left - sided diaphragm and cardiac contours . The pleural effusion reaches up to the hilar level along the lateral chest wall . Just in the hilar region and somewhat below , a few centimeters of spontaneous air bronchogram can be identified , but the periphery of the left lower parenchyma is concealed . The remaining upper portion of the left hemithorax demonstrates pulmonary vasculature , with unremarkable appearance . No pneumothorax is seen . The right hemithorax shows grossly normal findings . Right lateral and posterior pleural sinus is free . Skeletal structures of the thorax grossly unremarkable . Our records do not include a previous chest examination available for comparison .
    OUTPUT:
    
Sizable left - sided pleural effusion . Left lower lung tissue concealed . If course of pleural effusion has not been determined , evaluation of lung by CT is recommended .