Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: 2 lead left - sided pacemaker is again seen , stable in position . The cardiac and mediastinal silhouettes are stable . There is persistent obscuration of the left hemidiaphragm which may be due to a Bochdalek hernia as also seen on the prior study . No new focal consolidation is seen . There is no large pleural effusion although a trace right pleural effusion and is difficult to exclude as there is again blunting of the right costophrenic angle . No pneumothorax is seen . A VP shunt is noted coursing over the right hemi thorax .
    OUTPUT:
    
Possible trace right pleural effusion . Otherwise , no significant interval change .