Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Large layering bilateral pleural effusions are present , partially obscuring the mediastinal contour . There is moderate pulmonary vascular congestion with mild pulmonary edema . Nodular opacities in the left mid and upper lungs in the right upper lung may represent pulmonary nodules or superimposition of structures . There is no pneumothorax . A tracheostomy tube appears well positioned . Severe multilevel degenerative changes of the thoracic spine are noted .
    OUTPUT:
    
1 . Large layering bilateral pleural effusions . Superimposed lung base consolidation is impossible to exclude . 2 . Moderate pulmonary vascular congestion with mild pulmonary edema . 3 . Nodular opacities in bilateral lungs may represent pulmonary nodules or superimposition of structures .