Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Heart size can not be assessed with certainty because of overlying pleural and pulmonary densities on the right side . Probably no significant cardiac enlargement is present . Thoracic aorta unremarkable . A rounded density with an average diameter of close to 5 cm is seen in the right - sided paramediastinal position similar as noted on a preceding outside chest examination of ___ . Noteworthy is that at that time existing minor amount of pleural effusion that just blunted the lateral pleural sinus on the right side has now increased and reaches into the minor fissure and is increased along the right - sided lateral chest wall . The lateral view confirms this assessment . The left - sided hemithorax remains unremarkable and that includes the normal - appearing pleural space . No pneumothorax is present . Estimate of pleural effusion suggests 500 to 600 mL , provided that the densities are only caused by fluid , which in this patient with history of metastatic malignancy is questionable . .
    OUTPUT:
    
Moderately sized right - sided pleural density that has increased considerably since the next preceding outside chest examination dated ___ .