Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since recent exam , there has been significant interval enlargement of the large left pleural effusion . Minimal aerated lung seen superiorly . There is no mediastinal shift indicating some degree of left lung atelectasis . Small right pleural effusion is noted . Cardiac silhouette can not be assessed . Median sternotomy wires are identified .
    OUTPUT:
    
Large right - sided pleural effusion , significantly increased since prior exam .