Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A three - lead pacemaker / ICD device has leads terminating in the right atrium , right ventricle , and coronary sinus . The heart is again mild - to - moderately enlarged . The aortic arch is calcified . The mediastinal and hilar contours appear unchanged . There is a new vague nodular density projecting over the right lower lobe measuring approximately about 15 mm in diameter . Otherwise , the lungs remain clear . There is no pleural effusion or pneumothorax . Calcified pleural plaque has formed along the apex of the right hemidiaphragm as before . Small osteophytes are similar along the thoracic spine .
    OUTPUT:
    
New vague nodular focus projecting over the right lower lung , which may represent a focal infectious process versus a true pulmonary nodule , which could be either of infectious or neoplastic etiology . Atelctasis or consolidation are also possible . Correlation with clinical factors is recommended . Short - term radiographic follow - up is recommended within ___ weeks in order to show resolution if an infectious cause is suspected . Otherwise , chest CT could be considered .