FINDINGS:
Frontal and lateral views of chest were obtained.  Dual-lead
 left-sided pacemaker is again seen with leads extending to the expected
 positions of the right atrium and right ventricle.  Left perihilar opacity is
 again seen, grossly similar in appearance, consistent with known mass and
 parenchymal scarring.  There is persistent blunting of the left costophrenic
 angle which appears slightly increased since the prior study.  Left
 retrocardiac opacity may relate to combination of effusion and atelectasis,
 however underlying consolidation cannot be excluded.
   The right lung is clear.

IMPRESSION:
1.  Left pleural effusion which appears increased since the prior study.  Left
 retrocardiac opacity may relate to combination of effusion and atelectasis,
 however underlying consolidation cannot be excluded.
 2.  Left perihilar opacity consistent with known mass and parenchymal
 scarring.  Grossly stable appearance of the left perihilar region.