Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Leftward shift of mediastinal structures is unchanged and due to volume loss in the left upper lobe . Left upper lobe and left upper paramediastinal opacity is compatible with known lung malignancy and changes from prior radiation fibrosis . Small to moderate left pleural effusion persists , but appears decreased in size compared to the previous exam . The cardiac silhouette size also appears somewhat decreased compared to the previous exam , but remains mildly enlarged . There is no pulmonary vascular engorgement or pneumothorax . The right lung is clear . Streaky left basilar opacity likely reflects atelectasis but infection is not excluded . There are no acute osseous abnormalities .
    OUTPUT:
    
1 . Interval decrease in size of the cardiac silhouette suggestive of decreased pericardial effusion . Left pleural effusion also appears decreased in size , now small to moderate in extent . 2 . Unchanged opacity within the left upper lobe and left upper paramediastinal region compatible with known malignancy and radiation fibrosis changes . 3 . Streaky left basilar opacity likely reflects atelectasis though infection can not be completely excluded .