Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The left hemodialysis catheter terminates in the mid right atrium . The mediastinum is normal . The heart silhouette is obscured by bilateral pleural effusions and is not adequately evaluated . Large bilateral pleural effusions are not appreciably changed . A coarse calcification in the right hilum is likely a calcified lymph node . There is no apical pneumothorax .
    OUTPUT:
    
Large bilateral pleural effusions are not appreciably changed .