Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . There is again noted to be near complete opacification of the left hemi thorax with sparing of the left upper lung . As seen on recent CT , patient is known to have a large loculated left pleural effusion which is similar in overall extent compared with prior . There is mild shift of midline structures to the right . Right lung remains clear . Bony structures are intact .
    OUTPUT:
    
Persistent large loculated left pleural effusion resulting in near complete opacification of the left hemi thorax . Overall size is unchanged from prior exam from ___ .