Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral dual - lead pacer with trans - subclavian lead extending to the right atrium and right ventricle is in unchanged position . There is no pneumothorax or pleural effusion . Hyperexpansion suggests underlying chronic obstructive pulmonary disease . New from prior study , there are multifocal lower and middle lobe parenchymal opacities . Given the provided history and the apparent lack of infectious symptoms , these could represent amiodarone toxicity . This suggestion is supported by the increased density of the liver from ___ to ___ . The hilar and cardiomediastinal contours are unchanged . There is no pulmonary vascular congestion or pulmonary edema to suggest congestive failure .
    OUTPUT:
    
New multifocal parenchymal opacities in the lower and middle lobes bilaterally , which given concurrent increased hepatic density from ___ to ___ , could represent amiodarone - induced pulmonary toxicity . Differential would includes infectious processes in the proper clinical setting or organizing pneumonia . CT could be considered for further evaluation . This was discussed with Dr ___ at noon by Dr ___ on ___ via phone .