FINDINGS:
In comparison with the study of , the PICC line appears to be
 in the mid to lower portion of the SVC.  The overall appearance of the heart
 and lungs is essentially unchanged, though there is an artifact overlying a
 portion of the right lung.  Continued hyperexpansion of the lungs consistent
 with emphysema.  Atelectatic changes are seen at both bases.  The possibility
 of supervening consolidation in the posterior aspect of one of the lower lobes
 would be difficult to unequivocally exclude in the appropriate clinical
 setting.