Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided pacemaker projects leads into the right atrium and ventricle . Again seen is an elliptical right lower density , previously seen and described on the ___ chest CT examination . There is no pneumothorax or focal consolidation , or pleural effusion . The cardiac and mediastinal silhouette is unchanged .
    OUTPUT:
    
No acute intrathoracic process . The examination is unchanged since ___ .