Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views have been obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding similar study of ___ . The heart size remains unchanged and is within normal limits . Also unchanged appearance of thoracic aorta . No pulmonary vascular congestion is present . The right - sided hemithorax is unchanged and does not demonstrate any new infiltrates , masses or pleural effusion . On the left side , the previously identified mass lesion in the proximal portion of the left lower lobe has increased in size . It involves now also the periphery of the left lower lobe and reaches the pleural space . On the lateral view , one can identify a moderate amount of pleural effusion surrounding the mass . There is no evidence of any secondary metastases and no pneumothorax is identified in the apical area .
    OUTPUT:
    
Progression of left lower lobe mass into periphery and now having contact with pleural space with moderate amount of pleural effusion .