Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared to prior , the size of the moderate right - sided pleural effusion has increased . There is also a small left effusion . Cardiac silhouette is enlarged but stable in configuration . Left chest wall single lead pacing device is seen with lead tip at the right ventricular apex . There is new partially visualized cervicothoracic fixation hardware . No acute osseous abnormalities . Right PICC is seen with catheter tip over the axillary region .
    OUTPUT:
    
Interval enlargement of the now moderate right pleural effusion and small left pleural effusion . Right PICC tip projecting over the axillary region .