Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Moderate - to - large right pleural effusion accompanying lower lung atelectasis has increased since ___ . Mediastinal shift to the left side is secondary to the moderate - to - large right pleural effusion . Left lung is clear . There is no pleural abnormality . There is no pneumothorax . Because of the large right pleural effusion obscuring the right mediastinal border , assessment of the cardiomediastinal silhouette was limited . Hypodensity in the right upper quadrant and epigastric region is possibly from carcinoma .
    OUTPUT:
    
Moderate - to - large right pleural effusion accompanying right lower lung atelectasis and causing mediastinal shift to the left side , is worsened since ___ .