Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Oblique positioning , probably slightly RPO . The upper mediastinum is slightly underpenetrated and the tubes are not well seen . Allowing for this , I identify a single tube with its tip approximately 4 .7 cm above the carina , at the level of the mid clavicular heads . This is in nominal position for an ET tube . No definite and OG - tube is identified . The cardiac silhouette is massively enlarged . The level of the diaphragms of the obscured . There is hazy opacity in the right lung suggesting a layering right effusion with underlying collapse and / or consolidation . The upper and mid zones of the left lung are grossly clear , without CHF . There is retrocardiac density consistent with left lower lobe collapse and / or consolidation . The extreme left costophrenic angle is excluded from the film . No pneumothorax is identified . Background degenerative changes noted in the spine , not fully evaluated .
    OUTPUT:
    
1 . Only a single tube is visualized -- this appears to represent the ET tube , nominal in position . Clinical correlation regarding the OG tube is requested . 2 . Massive enlargement of the cardiac silhouette . The differential diagnosis includes marked cardiomegaly and a pericardial effusion . 3 . Layering right pleural effusion , with underlying collapse and / or consolidation . 4 . Left lower lobe collapse and / or consolidation . The upper portions of left lung are grossly clear , without overt CHF .