Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Right - sided PICC is grossly stable in position , terminating at the brachiocephalic / SVC junction . The lungs remain hyperinflated , in keeping with COPD . Chronic lung changes are noted at the lung apices . Left upper lobe patchy opacity projecting over the posterior left fifth rib , while could relate to vascular structures and / or scarring , underlying pulmonary lesion is not excluded . There are small bilateral pleural effusions , best seen on the lateral view . Cardiac and mediastinal silhouettes are stable and unremarkable .
    OUTPUT:
    
Right - sided PICC terminates at the brachiocephalic / SVC junction . Small bilateral pleural effusions . COPD . Left upper lobe patchy opacity projecting over the posterior left fifth rib , while could relate to vascular structures and / or scarring , pulmonary lesion is not excluded .