Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a right Port - A - Cath with its tip terminating in the proximal right atrium . The heart size is normal . The lungs are hyperinflated , likely reflective of COPD . A small left pleural effusion is again noted . There is a peripheral opacity in the right middle lobe , only seen on the lateral radiograph . Prominence of the pulmonary arteries is likely reflective of pulmonary arterial hypertension . Prior left rib fractures are noted .
    OUTPUT:
    
1 . New right middle lobe peripheral opacity may reflect pneumonia though a infarct is also a consideration in the appropriate setting . 2 . Small left pleural effusion .