Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is increased opacification of the left hemithorax . As seen previously , the left mid - to - lower hemithorax shows complete opacification with a large pleural effusion and net volume loss including leftward shift of mediastinal structures and elevation of the left hemidiaphragm . What is new on this examination is predominantly increased vague opacification of the residual aerated portion of the left upper lung . Since pulmonary markings can still be discerned through the veil - like opacity , the appearance is suspected predominantly reflect increasing pleural effusion along the major fissure , although it is difficult to completely exclude increasing atelectasis or consolidation . The right lung remains clear with compensatory hyperinflation . Bony metastases are not well visualized on this study for the most part , although a mid thoracic vertebral body appears largely sclerotic and potentially the degree of sclerosis has increased since the prior CT .
    OUTPUT:
    
1 . Increasing opacification of the left upper hemithorax , suspected to predominantly represent increasing pleural effusion , without other significant change in pulmonary findings . 2 . Sclerotic mid thoracic vertebral body ; although noting that metastases to the bones are mostly not well characterized , the possibility of increased bony metastatic disease since the prior CT should be considered .