Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: AP single view of the chest has been obtained with patient in sitting semi-upright position . Comparison is made with the next preceding similar study of ___ . The previously identified right - sided pleural effusion remains unchanged . It appears sizable as it obliterates completely the right - sided diaphragm and extends along the lateral chest wall on the right side . It also obscures the right middle lobe and lower lobe area , so a possible underlying pulmonary abnormality in this area can not be excluded . The left hemithorax is grossly unremarkable on this portable chest examination in semi-upright position .
    OUTPUT:
    
Sizeable right - sided pleural effusion . For further evaluation , a chest CT is recommended .