Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided pacemaker device is noted with single lead terminating in the right ventricle . Moderate cardiomegaly persists . Aortic knob is densely calcified . Mediastinal and hilar contours are unchanged . There is no pulmonary vascular congestion . Left basilar opacity likely reflects atelectasis . No large pleural effusion is seen though assessment for left - sided effusion is somewhat limited due to overlying pacemaker generator pack obscuring this region . And ill - defined 19 mm hazy nodular opacity within the right upper lung field is unchanged from ___ . Calcified granuloma in the left lung apex is unchanged . No pneumothorax is identified . Degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
1 . Retrocardiac opacity likely reflects atelectasis . Infection is difficult to exclude . 2 . Persistent 19 mm subtle ill - defined nodular opacity in the right lung apex . Finding are concerning for a neoplastic process , and further assessment with a chest CT is recommended .