Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with the study of ___ , there may be a slight increase in the small left apical pneumothorax . However , there has been a significant increase in the subcutaneous gas along the left lateral chest wall as well as in the neck , with substantial pneumomediastinum . Heart size , mediastinal contour , and hila are unremarkable . Left chest tube is unchanged in position .
    OUTPUT:
    
1 . Small left apical pneumothorax , no tension . 2 . Significant increase in subcutaneous gas along the left lateral chest wall and neck with substantial pneumomediastinum .