FINDINGS:
The heart is enlarged.  There is a small right pleural effusion and
 a small-to-moderate left pleural effusion.  Calcified lymph nodes are seen in
 the right hilum.  Otherwise, the hilar and mediastinal contours are normal. 
 The lungs are well expanded and clear. There are no focal consolidations.
 There is no pneumothorax.  A left-sided double-lumen dialysis catheter is seen
 with the tip in the right atrium.

IMPRESSION:
Small-to-moderate left pleural effusion and small right pleural
 effusion.