Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a large right pleural effusion . The lung markings in the right upper lobe are not well visualized . The cardiomediastinal silhouette and hila are normal . The left lung is clear . Pacemaker wires end in the right atrium and right ventricle .
    OUTPUT:
    
Large right pleural effusion and possible hydropneumothorax . Further workup with CT might be considered . Findings discussed with the covering physician , chest tube is planned .