Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are compared to previous exam from ___ . The lungs are hyperinflated with fibrotic changes suggestive of COPD . There is , however , no confluent consolidation . There may be a small right - sided pleural effusion . Cardiac silhouette and hilar contours are stable . Atherosclerotic calcifications are again noted at the arch . Osseous and soft tissue structures are unremarkable .
    OUTPUT:
    
New small right - sided pleural effusion . Otherwise , no significant interval change .