Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient is markedly rotated on today 's study , this limits assessment . A dual lead pacemaker appears to be unchanged in position . A right - sided PICC terminates in the mid SVC . The appearance of increased opacity in the right lung is likely in part due to projection , in part due to layering pleural effusion . The left lung appears grossly clear .
    OUTPUT:
    
Allowing for technical differences , there has been no significant interval change .