Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lordotic positioning . Cardiac silhouette is enlarged , but without gross change . The subcu ICD is again noted , allowing for differences in positioning this is probably unchanged in alignment . No definite change compared with ___ . Again seen is some patchy density in the perihilar region of the right greater than left lung , which could reflect some pulmonary vascular congestion . However , it is not clear that this appearance is fully characterized . Possible small right effusion , new or larger than on ___ . .
    OUTPUT:
    
Patchy appearance in the right perihilar lung of uncertain etiology or significance , similar to ___ . Question due to vascular plethora . However , the differential diagnosis could include infectious or inflammatory infiltrates . If clinically indicated , chest CT may help for further characterization . Small right effusion appears larger compared with ___