Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest demonstrate low lung volumes , which accentuate bronchovascular markings . Moderate left pleural effusion is present with associated parenchymal opacities ; these are partly nodular . A convex contour along the left lower medial hemithorax suggests a substantial hiatal hernia . A 3 mm round opacity projects over left upper hemithorax , unchanged . There is no right pleural effusion . The hilar and mediastinal silhouettes are unchanged . Aortic arch calcifications are again noted . Multiple surgical clips project over left hilar silhouette . Overlying sternal wires appear intact . Heart is mildly enlarged . There is no pneumothorax . Mitral valve prosthesis is noted . There is new destruction of the right posterior eighth rib with a possibly soft tissue mass .
    OUTPUT:
    
1 . Moderate left pleural effusion with adjacent opacity in the left lung base , which may represent atelectasis or infection in the appropriate clinical setting ; since the opacities are partly nodular , nodules in the left lower lung should also be considered . 2 . New right eighth rib destruction . 3 . Findings suggesting a moderate hiatal hernia although not entirely specific . Findings are worrisome for malignancy as demonstrated by a CT performed on the same day at the time of finalization of this report .