Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP upright and lateral chest radiograph demonstrates a moderate right pleural effusion and smaller left pleural effusion . Relative to CT dated ___ , allowing for differences in modality , this appears increased . Known left upper lung spiculated nodule suspicious for malignancy is not significantly changed . No opacity is identified convincing for pneumonia . Bibasilar atelectasis is moderate . Heart is enlarged . Hiatal hernia seen in the retrocardiac region on the frontal view . No evidence of pulmonary edema . There is no pneumothorax .
    OUTPUT:
    
Bilateral pleural effusions , right greater than left , appear increased relative to CT dated ___ , allowing for differences in modality . Known left upper lung spiculated nodule suspicious for malignancy is again seen .