Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again noted is a large right - sided pleural effusion with concurrent severe atelectasis of the right middle and lower lobes . Fluid is seen tracking into the right apex . The left lung and the right upper lung show no significan opacities . There is a trace pleural effusion on the left side that is mildly increased compared with ___ . Although the right heart border is obscured by above - mentioned abnormalities , the heart does not appear to be enlarged . The left hilar contours are unremarkable . There is no pneumothorax .
    OUTPUT:
    
No significant change compared with ___ with a large right - sided pleural effusion and concurrent severe atelectasis of the right middle and lower lobes . Pneumonia can not be completely excluded . Minimal interval increase of left - sided pleural effusion .