Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Consistent with the given history , large - bore dual - lumen dialysis catheter from a right internal jugular approach is in stable and standard course and position from a right internal jugular approach . A left internal jugular central venous catheter device has been removed in the interval . No consolidation or edema is evident . The mediastinum is unremarkable . The cardiac silhouette is enlarged . This is an interval change compared to the most recent prior study but has been noted on other prior studies . Subtle blunting of the right costophrenic angle suggests a tiny effusion . No pneumothorax is evident . There are no displaced fractures .
    OUTPUT:
    
Small bilateral pleural effusions . Interval marked enlargement of the cardiac silhouette relative to the most recent prior exam . However , other more remote exams have demonstrated enlargement of the silhouette , thereby suggesting the possibility of waxing and waning pericardial effusion . Correlate clinically .