Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The endotracheal tube tip sits between the clavicular heads . An endogastric tube courses inferiorly , out of field of view . The right - sided PICC tip sits at the cavoatrial junction . The cardiomediastinal contours are exaggerated by position and technique , although their apparent growth by about 1 cm over multiple prior exams is noted ; an additional contour projecting over the aortic arch represent a contained dissection / pseudoaneurysm and lymphadenopathy as seen on prior CT . There continues to be a moderate left pleural effusion with associated atelectasis . Mild pulmonary edema lingers . There is no pneumothorax .
    OUTPUT:
    
1 . Gradual mediastinal widening ; consider a follow - up radiograph in supine positioning . 2 . Mediastinal contours demonstrate the lymphadenopathy and contained dissection / pseudoaneurysm better seen on prior CT . 3 . Moderate left pleural effusion with underlying atelectasis and mild pulmonary edema ; underlying infection can not be excluded .