Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A right pleural effusion is moderate to large with associated compressive atelectasis and collapse of the right middle and lower lobes . The left pleural effusion is small , also with associated compressive atelectasis and left lower lobe collapse . Remaining aerated lungs are otherwise clear . Heart size is not well assessed in the presence of bilateral pleural effusions . No pneumothorax . Widening of the thoracic spine is similar to the prior exam with mild retrolisthesis of a lower thoracic vertebral body .
    OUTPUT:
    
Moderate to large right and small left pleural effusions with associated substantial volume loss .