Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided Port - A - Cath tip terminates in proximal right atrium , unchanged . Cardiac silhouette size is top normal . The mediastinal and hilar contours are similar with prominence of the pulmonary arteries as seen previously suggestive of underlying pulmonary arterial hypertension . Lungs are hyperinflated with emphysematous changes again noted in the upper lobes . Small left pleural effusion is noted . There is no pneumothorax . Remote left - sided rib fractures are re - demonstrated .
    OUTPUT:
    
Small left pleural effusion . Emphysema . No focal consolidation to indicate pneumonia .