Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs remain hyperinflated , compatible with COPD . Again noted is mild right lower lobe bronchiectasis . Increased opacification of the left lung base likely represents a small left pleural effusion . No pneumothorax or right pleural effusion is seen . No focal consolidation concerning for pneumonia is seen . The cardiac silhouette is normal in size . The mediastinal and hilar contours are within normal limits and unchanged from the prior study with tortuosity of the thoracic aorta .
    OUTPUT:
    
Small left pleural effusion . Otherwise , unchanged appearance of the chest from ___ .