Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi erect frontal image of the chest . A right - sided PICC terminates in the mid SVC . A tracheostomy tube is seen in place . Median sternotomy wires and mediastinal clips are noted . An additional catheter is seen overlying the abdomen . An opacity is seen in the left lung base , concerning for pneumonia . Increased mild opacity in the right mid lung may represent developing pulmonary edema . There is a moderate to large left pleural effusion and a moderate right pleural effusion . No pneumothorax is seen . The cardiomediastinal silhouette is obscured by adjacent opacities . Lucency is seen projecting over the mediastinum , which may represent air in the esophagus which would be concerning for a possible tracheoesophageal fistula .
    OUTPUT:
    
1 . Opacity in the left lung base , concerning for pneumonia . 2 . Increased mild opacity in the right mid lung may represent developing pulmonary edema . 3 . Bilateral pleural effusions , moderate to large on the left and moderate on the right . 4 . Suspected abnormality of the esophagus , possibly a tracheoesophageal fistula . Recommend comparison with old studies from outside hospitals . If no prior imaging is available and if further characterization is desired , Chest CT should be obtained for further assessment . Findings were communicated to Dr . ___ at 8 : 18 a .m . ___ by phone .