Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac silhouette remains enlarged . Mediastinal contours are stable . The lateral views are suboptimal due the patient 's overlying arm . Given this , there may be trace pleural effusions . Subtle increase in opacity projecting over the right hemi thorax as compared the left is felt to most likely be technical . Multiple surgical clips seen projecting over the lower cervical region suggest prior thyroidectomy .
    OUTPUT:
    
Suboptimal lateral views due to patient 's overlapping arm . Difficult to exclude trace pleural effusion .