Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: ET tube tip approximately 3 .2 cm above the carina . NG tube tip extending beneath diaphragm , off film . Left IJ central line tip at SVC / innominate junction . Tubing overlies the upper left chest immediately inside the chest wall --___ this represents a PICC line it has not reached the central venous vasculature . No pneumothorax detected . Background hyperinflation is consistent with COPD . Cardiomediastinal grossly unchanged . Compared with ___ , there is increased opacity at the left lung base with new obscuration of the left hemidiaphragm consistent with left lower lobe collapse and / or consolidation and small effusion . Better seen on the prior film , the the patient has a rib fracture in this area . There is some patchy opacity in the left suprahilar region , which is unchanged . ( This was described as a chronic fibrotic lesion in the left lobe ani prior report possibly post radiation . ) . Mild vascular plethora , without overt CHF . Atelectasis the right lung base . There is minimal blunting of the right costophrenic angle .
    OUTPUT:
    
Increased opacity at the left lung base consistent with small effusion underlying collapse and / or consolidation . The differential includes a pneumonic infiltrate . Previously identified rib fracture in this area and not well seen on today 's study . Is a PICC line present ? -- if so , concern regarding its location . Please see comment above .