Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: With given for differences in technique it is difficult to discern with the left small pleural effusion and associated atelectasis / consolidation have significantly changed . No pneumothorax . The heart remains enlarged .
    OUTPUT:
    
The left small pleural effusion and associated lingular atelectasis / consolidation appear smaller however can be related to a more upright position and difficult to discern in the absence of a lateral radiograph .