IMPRESSION:
In comparison with the study of , there is again diffuse patchy
 opacification involving the right hemithorax with 8 generalized haziness, most
 likely representing layering pleural effusion with compressive atelectasis and
 continued mild elevation of pulmonary venous pressure.  The large spiculated
 mass is again seen in the right perihilar region.  Again, CT would be
 necessary for further characterization of this process.