Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a small left pleural effusion with overlying atelectasis , grossly stable as compared to the prior study . The lungs remain hyperinflated with flattening of the diaphragms , suggesting chronic obstructive pulmonary disease . No pneumothorax or new focal consolidation is seen . The cardiac and mediastinal silhouettes are stable . No displaced fracture is seen .
    OUTPUT:
    
Small left pleural effusion again seen , relatively stable .