Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes remain extremely low resulting crowding of the bronchovascular structures . This fact , in addition to patient body habitus , severely limit the sensitivity of this examination for the detection of subtle pneumonia . Within this limitation , there is no lobar consolidation , large pleural effusion , or overt pneumothorax . The cardiomediastinal silhouette appears similar to the prior examination . A vagal nerve stimulator overlies the left chest wall .
    OUTPUT:
    
Extremely limited examination without evidence for large consolidation .