Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The right PICC is malpositioned and courses upwards within the right internal jugular vein . Mild enlargement of the cardiomediastinal silhouette , which may be projectional . No focal consolidations . No pulmonary edema . Stable elevation / eventration of the right hemidiaphragm . No pleural effusion . No pneumothorax . Fusion hardware noted projecting over the lower cervical spine , not fully evaluated on this exam . Narrowing of the right shoulder acromial humeral distance --___ can be seen with rotator cuff thinning and / or tearing .
    OUTPUT:
    
Malpositioned right PICC coursing upwards within the right internal jugular vein .