Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest provided . Left chest wall pacer is again noted with single lead extending into the right ventricle . There is a prosthetic mitral valve . Midline sternotomy wires again noted . There is complete opacification of the right hemi thorax common new from prior with mild shift of midline structures to the left . There is a tiny left pleural effusion with left lung remaining mostly clear . No pneumothorax . Bony structures appear grossly intact though patient is known to have sclerotic bony metastatic disease , which are better appreciated on CT .
    OUTPUT:
    
Opacification of the right hemi thorax with mild shift of midline structures to the left .