Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the chest radiograph ___ , the distal end of a left - sided PICC is not clearly identified . Mild elevation of the left hemidiaphragm and scarring of the left lung base are unchanged . The lungs are otherwise fully expanded and clear without focal consolidations or effusions . Heart size is normal . Cardiomediastinal hilar silhouettes are normal . Median sternotomy wires are midline and intact .
    OUTPUT:
    
Distal end of the left - sided PICC is not clearly identified . Recommend lateral chest radiograph for further evaluation .