Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Paraspinal clips on the left are again visualized . The lungs are clear without infiltrate . There is blunting of the left CP angle that could represent a small effusion . Heart size is slightly enlarged compared to prior . The right hemidiaphragm is not as elevated as on the prior study . The right - sided PICC line is no longer visualized .
    OUTPUT:
    
Small left effusion .