Change: There is right sided pleural opacity- probably pleural thickening.The lateral projection image demonstrates loss of clarity of the right hemidiaphragm (silhouette sign). The arrowed opacity is not an interlobar effusion- it is a combination shadow produced by the combined opacity fof the cardiac shadow and the right hemidiaphragm   View changes from previous version. (Word count: 218)

Change: The term combination shadow refers to a plain film appearance that is the result of a combination density of two separate anatomical structures. It could   View changes from previous version. (Word count: 209)