Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The study is somewhat limited due to patient rotation . Left - sided AICD / pacemaker device is noted with leads terminating in the right atrium and right ventricle , unchanged . Multiple mediastinal clips are again demonstrated . Moderate cardiomegaly is again seen . Left lower lobe opacification appears slightly worse when compared to the prior radiograph , likely reflecting a combination of patient 's known malignancy with atelectasis and / or infection superimposed . There is mild pulmonary vascular congestion , which is increased compared to the prior study . Small bilateral pleural effusions are likely present . There is no pneumothorax .
    OUTPUT:
    
Increased opacification within the left lower lobe likely reflecting a combination of the patient 's known malignancy with atelectasis and / or infection superimposed . Small bilateral pleural effusions . Mild pulmonary vascular congestion .