Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large left - sided pleural effusion obscuring the left heart border . There is a lucency which projects over the density , which could be suggestive of a loculated effusion , however another source of air can not be excluded . There is no evidence of a pneumothorax . No focal consolidations concerning for infection are otherwise seen . The lungs bilaterally demonstrate nodular densities , likely secondary to granulomas . The visualized osseous structures are unremarkable . There is slight contralateral deviation of the carina .
    OUTPUT:
    
Large left - sided pleural effusion with areas of lucency projecting over the density . This could be suggestive of a loculated effusion , however another source of air can not be excluded . A PA and lateral radiograph would be helpful for further evaluation . These findings were discussed with Dr . ___ at 3 : ___p by telephone by Dr . ___ ___ on the day of the exam .