Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right PICC line again projects superiorly in the neck , in the right jugular vein . Tracheostomy tube , enteric tube , and left subclavian line are unchanged . Bilateral pleural effusions and significant atelectasis ( bilateral lower lobe collapse ) is overall unchanged . Thoracic fusion hardware partially obscures the central mediastinum .
    OUTPUT:
    
Malpositioned right PICC projecting in the right jugular vein superiorly , should be repositioned . Otherwise , little overall change .