Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiomediastinal contours are normal . Large left pleural effusion has markedly increase from prior with increasing adjacent atelectasis . The right lung is clear . There is no pneumothorax or right pleural effusion . Multiple left rib fractures and comminuted fracture of the a left clavicle are again noted .
    OUTPUT:
    
Marked increase in large left pleural effusion