Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi-erect chest radiograph ___ at 07 :41 is submitted .
    OUTPUT:
    
Right subclavian PICC line and right internal jugular Swan - Ganz catheter unchanged in position . There has been no interval change in the diffuse bilateral parenchymal process which could represent severe pulmonary edema , although pulmonary hemorrhage or a diffuse infectious process could have a similar appearance . Clinical correlation is recommended . There is likely a small layering left effusion . Given the diffuse airspace process , assessment of cardiac and mediastinal contours is difficult . No obvious pneumothorax .