Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Please note the lateral aspect of the lower chest wall was excluded from view . Ill - defined opacity is again noted at the right lower lung similar to the prior exam . There is slightly better definition of the left hemidiaphragm relative to the prior exam . A nodular density projects in the left upper lung between the posterior aspects of the left fifth and sixth ribs . There is no focal consolidation . Aortic tortuosity with calcified plaque throughout is again seen . There are prominent bilateral pulmonary arteries . The cardiac silhouette remains enlarged . No pneumothorax is seen . There are no definite displaced fractures evident . Calcifications are again seen in the right axilla .
    OUTPUT:
    
There is presumably a layering pleural effusion at the right lung base . The left lower lung zone is better aerated than on the prior study . There is cephalized flow of the vascular distribution , however that is likely due to recumbency .