FINDINGS:
Frontal and lateral views of the chest demonstrate a left pectoral
 dual-lead pacer/AICD with leads terminating in the right atrium and right
 ventricle.  The heart is normal in size.  There is mild thoracic aortic
 unfolding.  Atherosclerotic calcifications are seen in the arch.  
 Suspected right middle lobe mass is present since at least  and
 previously evaluated on CT.  Right basilar fibrosis is also better
 demonstrated on prior CT.   Aerated upper lungs are clear.  There is no
 pneumothorax, vascular congestion, or pleural effusion.

IMPRESSION:
1.  No acute cardiopulmonary process.
 2.  Probable right middle lobe mass, better assessed on prior CT.\
 3.  Right bibasilar pulmonary fibrosis.