Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tracheostomy tube is again identified . Calcified granuloma seen in the right upper lung . There is at least moderate - sized layering effusion on the right and possible layering effusion on the left as well given hazy opacity overling the lung . Superimposed consolidation in the mid lungs , left greater than right again seen . The cardiomediastinal silhouette is unchanged . No acute osseous abnormality is identified . Left - sided PICC is seen with tip at the RA / SVC junction .
    OUTPUT:
    
Persistent at least moderate right effusion and possible layering left effusion . Underlying parenchymal opacities particularly in the midlungs are unchanged from prior .