Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lung volumes are low which limits assessment . A left - sided tunneled dialysis catheter is in - situ , unchanged in appearance when compared to the prior study . A tracheostomy in - situ . A right - sided PICC terminates in the LS . Pain in cell drain is in - situ small is unchanged in appearance when compared to the prior study there may be a small adjacent pneumothorax . This area is difficult to evaluate . There is persistent prominence of the pulmonary vasculature consistent with pulmonary vascular congestion . Increased opacity is right noted in the right lower lung likely reflect a combination of both pleural effusion and atelectasis .
    OUTPUT:
    
Possible loculated pneumothorax at this site of the pigtail catheter . This area is very difficult to evaluate .