Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a moderate left pleural effusion without findings to suggest tension . There is no mediastinal shift . There may be a small left pleural effusion . Left perihilar opacity and retraction is seen , which is likely chronic and may relate to patient 's history of lung cancer . Subtle left lower lung , infrahilar opacity may relate to decreased left lung volume or could relate to history of malignancy , given no prior imaging available for comparison . Left lung base atelectasis / scarring is seen . The right lung is clear and hyperinflated , likely due to underlying COPD . The cardiac silhouette is top - normal to mildly enlarged . The aorta is calcified . Minimally displaced fracture of the posterior left 7th rib is seen . There are also fracture deformities of the more superior ribs , including the left posterior ___ and 5th ribs of indeterminate age and possibly the posterior left 3rd rib .
    OUTPUT:
    
1 . Moderate left pneumothorax without findings to suggest tension . Possible small left pleural effusion . Left - sided rib fractures , as above , some of which may be subacute . 2 . Left perihilar opacity is likely chronic . Left infrahilar / lower lobe opacity most likely relates to decreased lung volume / atelectasis due to the left pneumothorax , however , could relate to patient 's malignancy , prior imaging is not available for comparison . The above findings were discussed with Dr . ___ in the ___ emergency department at 18 : 40 on ___ via telephone ___ min after discovery .