Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral images of the chest were obtained with the patient in the upright position . Again seen are surgical clips in the right hilum and volume loss in the right lung consistent with right middle lobectomy . There is a small persistent right effusion , the left lung is clear . Cardiomediastinal silhouette is unchanged from previous imaging . Visualized osseous structures are unremarkable .
    OUTPUT:
    
Essentially unchanged chest radiograph from previous imaging . Right pleural effusion .