Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Endotracheal tube tip is low lying and terminates approximately 2 .3 cm from the carina . A nasogastric tube tip appears to be within the stomach . A catheter likely reflecting a chest tube is seen entering via a right basilar approach , with tip terminating adjacent to the right hilum . Lung volumes are low . The heart size is normal . The aorta remains tortuous and diffusely calcified . There is no pulmonary vascular congestion . Previously noted small right pleural effusion appears slightly decreased in the interval . The right costophrenic angle however is excluded from the field of view . Blunting of left costophrenic angle is unchanged compared to the prior study , and is likely reflective of a small left pleural effusion . Retrocardiac opacification appears progressed when compared to the prior study , and could reflect infection , atelectasis , or aspiration . Expansile metastatic lesion involving the left ___ and 3rd ribs with osseous destruction is again noted as well as a metastatic lesion involving the right 4th rib . There is no definite pneumothorax .
    OUTPUT:
    
1 . Interval decrease in size of the right pleural effusion which is small , though not completely assessed as the right costophrenic angle is excluded from the field of view . 2 . Worsening opacification in the retrocardiac region which could reflect worsening atelectasis , aspiration , or infection . 3 . Small left pleural effusion . 4 . Low lying endotracheal tube terminates approximately 2 .3 cm from the carina , and should be withdrawn for optimal placement . 5 . Unchanged metastatic lesions involving the left ___ and 3rd ribs as well as the right 4th rib .