Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable supine chest radiograph shows no change in positioning of a large bore right IJ central venous catheter . Since yesterday , the patient has been endotracheally intubated and the tip of the endotracheal tube is 4 cm above the carina and the cuff appears maximally inflated . Dense obscuration of the right hemidiaphragm and perihilar region persists with suggestion of the right hilar or perihilar mass , unchanged from previous studies . The heart appears enlarged . The left hemidiaphragm is also obscured and speckled density of the spleen is visible . Bones are diffusely sclerotic .
    OUTPUT:
    
Endotracheal tube tip 4 cm above carina with cuff maximally inflated . Pulmonary parenchymal findings largely unchanged .