Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest demonstrate diffuse bilateral pulmonary nodules which are unchanged from ___ . There has been interval increase in the size of the large left pleural effusion , now with some adjacent atelectasis in the left upper lung zone . There is no pleural effusion in the right lung . Again seen is a single - chamber pacemaker with tip terminating in the right ventricle , in the standard position . No pneumothorax . Right - ward shift of the mediastinum is unchanged .
    OUTPUT:
    
Interval increase in size of large left - sided pleural effusion with adjacent atelectasis .