Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Patient was examined in upright position using PA and lateral chest view projections . Patient is mildly tilted towards the left on the frontal view . One observes now a total white out of the right hemithorax with only mild degree of mediastinal shift towards the left . Considering patient 's clinical history and radiographic evidence of several large right - sided pleural effusions treated with successful thoracocentesis ( ___ ___ and ___ ) this most likely represents reaccumulation of the pleural effusion . The apparently massive pleural effusion obscures partially the central airways and the possibility of a centrally located right main bronchus narrowing or occlusion just distal to the carina can not be excluded completely but is less likely the cause of the complete right - sided pulmonary white out . The left hemithorax does not show any evidence of acute infiltrates or pulmonary vascular congestive pattern . Heart size and configuration appears unaltered .
    OUTPUT:
    
Massive new right - sided pleural effusion resulting in total white out . Situation was discussed with Dr . ___ ___ page 5 :30 p .m .