Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral views of the chest were obtained . A dual - lead left - sided AICD is again seen with leads extending to the expected positions of the right atrium and right ventricle . The right costophrenic angle is not fully included on the image . There are bilateral pleural effusions , which may be at least partially loculated . Right upper lobe / suprahilar opacity underlying fiducial seed has increased since the prior study , raising concern for progression of malignancy . Streaky right infrahilar opacity underlying chain sutures , may relate to chronic changes , although appears to have increased since the prior study . The cardiac and mediastinal silhouettes are stable .
    OUTPUT:
    
1 . Increased nodular opacity in the medial right apex / right suprahilar region underlying fiducial seeds , worrisome for progression of malignancy . 2 . Bilateral left greater than right pleural effusion , which is likely loculated at least on the left . 3 . Right infrahilar streaky opacity may relate to prior surgery / chronic changes but more acute component not excluded .