Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The patient remains intubated . There is a three - lead pacemaker / ICD device in place . The patient is status post sternotomy and coronary artery bypass graft surgery . There is again a stent in the bronchus intermedius and confluent opacification in the right lower lung , probably involving the right middle lobe . Elsewhere heterogeneous opacities have improved substantially . There is a small pleural effusion on the right ; there is no definite persistent pleural effusion on the left .
    OUTPUT:
    
Improvement in multifocal opacities aside from persistent unchanged right lower lung opacity , probably in the right middle lobe . The latter opacity may be explained by pulmonary hemorrhage , and particularly based on prior findings and the dense lobulated apperance of opacities , concern is for hemorrhagic metastatic disease in the right middle lobe appear