FINDINGS:
The lung volumes have decreased.  Signs of chronic interstitial
 fluid overload.  Marked increase of the cardiac silhouette that is now
 moderately to severely increased.  A central venous access line for dialysis
 has been placed over the right, the tip of the line projects over the right
 atrium.  Mild bilateral pleural effusions.  No hilar or mediastinal
 lymphadenopathy.  No pneumonia.  No lung nodules or masses.