Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the study of ___ , there is again bilateral pleural effusions , the left pleural effusion has increased now moderate to large . Small right - sided pleural effusion is stable . Densely calcified lymph nodes are again seen in the left hilum and there are intact midline sternal wires and a cervical fusion device . No pulmonary edema .
    OUTPUT:
    
Interval increase in the left - sided pleural effusion which is moderate to large .