Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lung volumes are low . A focal opacity in the right lower lung zone may represent atelectasis , though pneumonia can not be excluded . There is mild vascular congestion , though no frank pulmonary edema . A nodule in the right upper lung zone appears grossly similar to the prior radiograph , and is better characterized on the CT . There is a moderate - sized right pleural effusion and a small left pleural effusion . Both have increased from the prior exam . There is no pneumothorax . The aorta is tortuous . The cardiomediastinal silhouette is otherwise normal . Degenerative changes are noted in the spine with mild loss of height in multiple vertebral bodies , similar to the prior exams . The known severe compression fracture in L1 is not well visualized due to the overlying soft tissues .
    OUTPUT:
    
1 . Moderate right and small left pleural effusions , both increased in size from ___ . 2 . Right lower lobe opacity may be compressive atelectasis from the adjacent effusion , though pneumonia is difficult to exclude . 3 . Vascular congestion , without frank pulmonary edema . 4 . Unchanged right upper lobe pulmonary nodule , better characterized on the prior CT .