Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker with leads terminating in right atrium and right ventricle is in unchanged position . Cardiomegaly is again present . A right lower lobe opacity is again present and certainly could represent pneumonia in the correct clinical setting . Other considerations to be atelectasis versus layering effusions .
    OUTPUT:
    
Right lower lobe opacity , which in the correct clinical setting could certainly be pneumonia .