Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again , the cardiac mediastinal silhouette are unchanged with enlargement of the cardiac silhouette . ___ fiducial markers are seen projecting over the left lower lobe . No appreciable pneumothorax . Vascular calcifications of the aortic arch are noted . There are surgical clips in the right likely projecting within the right breast . There is increased opacity projecting over the lower lobes on the lateral view , which may be related to an increase in atelectasis , or perhaps hemorrhage related to fiducial marker placement . Degenerative changes at the left shoulder are again noted .
    OUTPUT:
    
No appreciable pneumothorax status post left - sided fiducial marker placement .