Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison to the most recent study , there has been increase in size of the left pleural effusion , with considerable new increased density at the left lung apex , which may represent loculated pleural fluid . Some residual lucency is seen at the uppermost left lung apex raising the question of a residual hydro pneumothorax versus a small area of residual aeration at the lung apex . There is likely underlying compressive atelectasis the left lung . Again seen is a left chest tube coursing along the base and medial side of the left lung . Vascular congestion is similar to the prior examinations . Focal consolidation is not excluded . Incidental note is made of degenerative change at the left shoulder , with focal hydroxyapatite / calcific tendonitis .
    OUTPUT:
    
Increasing left pleural effusion , possibly loculated . Likely underlying compressive atelectasis . Focal consolidation may be underlying . A small pneumothorax can not be excluded . If clinically indicated , CT scan can be obtained for more detailed evaluation . The right lung remains grossly clear , with minimal blunting of the costophrenic angle but no gross effusion .