Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with the prior study , no change in the left - sided pacemaker , with leads projecting to the right atrium and right ventricle . The lungs are clear without focal consolidation , pleural effusion , or pneumothorax . Cardiomediastinal silhouettes are unchanged . Nodular opacity in the right lower lung corresponds with a calcified granuloma identified on the recent chest CT .
    OUTPUT:
    
No acute intrathoracic process .