Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The PICC line tip is only minimally higher than on the prior exam and is in the distal SVC . There has been interval increase in the left pleural effusion which is now large in layering posteriorly with only a small amount of aerated lung in the superior left upper lobe . The right hemidiaphragm is obscured secondary to volume loss / infiltrate / effusion . This is a worsened appearance compared to prior .
    OUTPUT:
    
Worsened appearance to the lungs . . Some of this may be due to fluid overload but an infectious infiltrate in either lower lobe ca n't be excluded