Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A large - bore dual - lumen dialysis catheter is in stable course and position from a right internal jugular approach . Lung volumes are diminished . No consolidation or edema is evident . There is hemidiaphragm flattening suggestive of underlying obstructive lung disease . Aortic tortuosity is again noted but stable . The cardiac silhouette remains within normal limits for size . There is subtle blunting of the right costophrenic angle posteriorly which may indicate a small effusion . No large effusion is noted . There is no pneumothorax . Mild degenerative disease is seen in the mid thoracic spine .
    OUTPUT:
    
Underlying COPD . No definite superimposed acute process . Stable dialysis catheter .