Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is substantial cardiomegaly . A left lower lobe opacity is overall unchanged from the prior exam . There is likely a small right pleural effusion , which is unchanged . There is no evidence of pneumothorax . No other significant change from the prior study .
    OUTPUT:
    
Left lower lobe opacity not significantly changed . No significant change from the prior exam .