Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacer device is again noted with leads terminating in the right atrium and right ventricle . Heart size is normal . Leftward deviation of the trachea due to enlargement of the right thyroid lobe is unchanged . Re - demonstrated is pleural thickening , chronic opacification and volume loss in the left upper lobe , unchanged , compatible with post radiation changes for prior Hodgkin 's disease with similar superior retraction of the left hilum . Enlargement of the main pulmonary artery is similar to the previous exam . Streaky opacity is demonstrated in the right lung base . Pulmonary vasculature is not engorged . Small left pleural effusion is new . No pneumothorax is present . There are no acute osseous abnormalities . Clips project over the left upper quadrant of the abdomen and epigastric region .
    OUTPUT:
    
1 . Small left pleural effusion . 2 . Streaky right basilar opacity , possibly atelectasis , but infection is not excluded . 3 . Post radiation changes in the left upper lobe . 4 . Unchanged dilatation of the main pulmonary artery .