Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The right pleural effusion has increased and is now moderate in size with overlying atelectasis , underlying consolidation can not be excluded . There may be a very trace left pleural effusion , decreased in size since the prior . The cardiac silhouette remains enlarged . The aorta is calcified and tortuous . Evidence of hiatal hernia is again seen . The lateral view is suboptimal due to the patient 's overlying arm . A few punctate calcifications in the lung apices may represent calcified granulomas or may be related to scarring .
    OUTPUT:
    
Increased right pleural effusion which is now moderate , with overlying atelectasis , underlying consolidation can not be excluded . Trace left pleural effusion , slightly decreased .