Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Overall , there is a similar appearance of the chest compared to the prior study . Large left pleural effusion , with overlying atelectasis and findings compatible with known chronic aspiration are again seen . Smaller right pleural effusion and basilar consolidation are similar . Superimposed mild vascular congestion is also noted .
    OUTPUT:
    
Bilateral pleural effusions , left greater than right , with underlying severe emphysema and mild pulmonary vascular congestion . Similar appearance of bilateral opacities likely reflect chronic aspiration versus pneumonia .