Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single portable view of the chest . Tracheostomy tube is again noted . Right - sided PICC tip is in the upper SVC . Dense retrocardiac opacity is again seen silhouette the hemidiaphragm suggestive of pleural effusion . There is no large right pleural effusion . No definite evidence of pulmonary vascular congestion noting increased interstitial markings suggestive of chronic underlying lung disease . Cardiomediastinal silhouette is unchanged . Old nonunited right humeral fracture is again seen .
    OUTPUT:
    
No significant interval change . Persistent moderate left pleural effusion without definite evidence of pulmonary vascular congestion .