Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette is markedly enlarged , but stable in size , with indwelling right atrial and right ventricular pacing leads unchanged in position . The lungs are well expanded and grossly clear except for a small calcified granuloma at the left lung apex . There are no pleural effusions or acute skeletal findings .
    OUTPUT:
    
Stable marked cardiomegaly without evidence of pulmonary edema .