Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Examination is somewhat limited secondary to patient positioning . There are very low lung volumes , which results in bronchovascular crowding . Again seen is opacification in the left base , which likely represents a combination of atelectasis and pleural effusion . The left effusion is likely partially loculated . Pneumonia could be considered in the appropriate clinical setting . Right lung is clear except for a nonspecific patchy opacity at the base . The cardiac silhouette remains enlarged . A pacemaker device is present , with a single lead terminating in the region of the right ventricle . Right lung apex and superior mediastinum are obscured by overlying structures due to flexed position of the neck .
    OUTPUT:
    
Limited study secondary to patient positioning . Opacification of the left base may represent a combination of atelectasis and pleural effusion , however pneumonia could be considered in the appropriate clinical setting . Repeat radiograph with improved positioning may be helpful for initial further evaluation .