Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Study is limited as the left costophrenic angle is excluded from the field - of - view . Left - sided dual - chamber pacemaker with leads terminating in the right atrium and right ventricle is unchanged . Again noted is a left upper lobe paramediastinal mass . Opacification in the left lung base likely reflects a combination of a moderate - to - large pleural effusion and adjacent atelectasis . The right lung is grossly clear . There is no pulmonary vascular congestion .
    OUTPUT:
    
No significant interval change from the prior exam . No evidence of congestive heart failure . Persistent left pleural effusion and left basilar opacity likely reflective of atelectasis . Left upper lobe paramediastinal mass compatible with known malignancy .