Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Compared with ___ at 11 : ___ , small biapical pneumothoraces are again seen . The right apical pneumothorax is probably very slightly larger . The left chest tube remains in place . The patient is status post tracheostomy . A right - sided central line and right subclavian PICC line are both present , with tips both over the distal SVC . Cardiomediastinal silhouette is unchanged . There are hazy relatively diffuse alveolar opacities in both lungs . Below the appearance may be accentuated by technique , the appear slightly more pronounced and confluent on the current examination . No gross effusion . Upper zone redistribution noted .
    OUTPUT:
    
1 . Bilateral small apical pneumothoraces , slightly larger on the right . 2 . Slight increase in the prominence of the bilateral alveolar opacities . The differential diagnosis is extensive and best correlated clinically . The differential diagnosis includes early CHF , residua from contusions , pneumonic infiltrates or early ARDS .