Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker is in adequate position with leads terminating in the right atrium and right ventricle , expected locations . The heart remains enlarged and is essentially unchanged since ___ . There is a small left pleural effusion which appears increased in size when compared to prior examination . Lungs are otherwise clear . There is no pneumothorax . Rightward deviation of the trachea with an adjacent area of increased opacity is suggestive of a thyroid mass .
    OUTPUT:
    
1 . Left - sided pacemaker with leads in adequate position . 2 . Increased small left pleural effusion . 3 . Rightward deviation of the trachea may be suggestive of a thyroid mass . Clinical correlation is recommended .