Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A portable supine frontal chest radiograph demonstrates interval placement of an endotracheal tube , with the tip terminating 3 .3 cm above the carina . Apparent change in tracheal caliber at the thoracic inlet is seen on multiple prior images . A dual lead left - sided pacer is unchanged in position , with the leads overlying the right atrium and ventricle . A right - sided PICC is retracted compared to prior exam , with the tip now terminating in the mid SVC . Diffuse airspace opacities are redemonstrated , with increased opacity in the right upper lung and a new opacity in the left upper lateral lung . This could represent multifocal pneumonia , or an infectious process superimposed on asymmetric pulmonary edema . In the appropriate clinical setting , the differential could include other causes of alveolar opacities . There are again probable bilateral layering pleural effusions . No pneumothorax is identified .
    OUTPUT:
    
1 . Interval placement of an endotracheal tube , with the tip terminating 3 .3 cm from the carina . 2 . New focal opacity in the left upper lateral lung and the right upper lung , consistent with progression of multifocal pneumonia or an infectious process superimposed on asymmetric pulmonary edema . 3 . Retraction of a right - sided PICC , with the tip now terminating in the mid SVC . 4 . Probable bilateral layering pleural effusions .