Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A tracheostomy tube is present . A gastric tube extends into the stomach . The tip of the right PICC line projects over the upper right atrium . Increasing left lower lobe opacification which again may reflect atelectasis or pneumonia . A small layering left pleural effusion is also suspected . No pneumothorax identified . The size of the cardiomediastinal silhouette is within normal limits .
    OUTPUT:
    
Interval placement of a tracheostomy tube . Increasing opacity at the left lung base may reflect atelectasis and / or pneumonia . A small layering left pleural effusion is also suspected .