Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Exam is limited secondary to patient positioning , his chin overlies the lung apices bilaterally . Coarse interstitial markings seen throughout the lungs bilaterally which have been chronic back to ___ . There are small bilateral pleural effusions . Enlarged cardiac silhouette has not significantly changed given differences in positioning and technique . Accentuated thoracic kyphosis is again noted . Osseous structures are not well assessed due to osteopenia .
    OUTPUT:
    
Small bilateral pleural effusions without definite superimposed acute cardiopulmonary process given limitations of positioning .