Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is a a right - sided indwelling catheter and left sided dual lead pacemaker , grossly unchanged . Also again seen is a small left apical pneumothorax , unchanged . There is upper zone redistribution and mild vascular blurring , consistent with interstitial thickening . The small to moderate right pleural effusion with underlying right base collapse and / or consolidation is unchanged . Patchy opacity at the left base is similar , though perhaps slightly more pronounced on the current film . There is increased obscuration left hemidiaphragm and blunting of left costophrenic angle .
    OUTPUT:
    
1 . Overall appearance is quite similar to the prior film , but with probable increased opacity at the left base . 2 . Vascular plethora and interstitial thickening could reflect CHF , but as noted on yesterday 's CT scan , lymphangitic spread of tumor could give rise to similar appearance . 3 . Small left apical pneumothorax unchanged . Small right pneumothorax seen on ___ CT not visualized radiographically . 4 . Small to moderate right effusion with underlying collapse / consolidation unchanged .