Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead pacemaker device overlying the left hemithorax has leads in appropriate position in the right atrium and right ventricle . An additional abandoned lead is identified within the right ventricle . The aorta appears tortuous . Borderline cardiomegaly is present . Interstitial nodularity within the left lung is concerning for metastatic lymphangitic spread of carcinoma in the correct clinical setting . Hazy opacification along the right mid lung may represent pleural effusion . An avascular lucency surrounded by a slightly dense curvilinear margin within the right lower lung base may may represent air and fluid within the pleural space . Pleural plaques are noted bilaterally . Dense osseous lesions in the vertebral bodies may represent blastic metastasis .
    OUTPUT:
    
1 . Interstitial nodularity within left lung may suggest metastatic lymphangitic spread of carcinoma ; correlate with patient 's clinical history . 2 . Dense osseous lesions in vertebral bodies are also concerning for blastic metastases . 3 . Avascular lucency surrounded by a slightly dense curvilinear margin within the right lower lung base may may represent air and fluid within the pleural space .