Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Pacer unit projects over the left chest with leads in the right atrium and right ventricle . The heart size is at the upper limits of normal . The mediastinal contours demonstrate mildly tortuous aorta with calcified atherosclerotic disease of the aortic knob . The lungs demonstrate bibasilar atelectasis with small right and moderate left pleural effusions ; this may represent a component of inflammatory reaction from rib lesions or the pathologic fracture seen at the left costophrenic angle . Additionally , an area of lentiform pleural thickening is seen along the right mid chest wall in the area of a rib irregularity either representing a fracture or metastatic lesion . There is no pneumothorax .
    OUTPUT:
    
Persisting right small and left moderate pleural effusions with associated atelectasis as well as pleural reaction adjacent to destructive bony lesions as described above .