Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left pectoral pacemaker is again seen with leads terminating in the right atrium and right ventricle . There is no evidence of lead fracture or discontinuation . Mediastinal clips , coronary artery stents and sternotomy wires are constant . The lungs are hyperinflated , compatible with known COPD . Cardiac silhouette remains moderately enlarged . There is a new right perihilar mass , which warrants further investigation with CT . Small bilateral pleural effusions with overlying atelectasis are new . There is no focal airspace consolidation worrisome for pneumonia . No pneumothorax . There are moderate degenerative changes of the thoracic spine .
    OUTPUT:
    
1 . Right hilar mass , worrisome for neoplasm , warrants further evaluation with a contrast enhanced chest CT . 2 . New small bilateral pleural effusions .