Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Exam is suboptimal due to underpenetration , or presumed secondary to patient body habitus . The cardiac silhouette is enlarged . The mediastinum is also widened however , given patient body habitus , this may be due to mediastinal lipomatosis . Central pulmonary vascular congestion .
    OUTPUT:
    
Suboptimal study due to underpenetration presumed secondary to patient body habitus . Enlarged cardiomediastinal silhouette . Possible underlying mediastinal lipomatosis . Possible central pulmonary vascular engorgement .