Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Extensive subcutaneous emphysema throughout the thorax and lower neck is unchanged and limits evaluation of the underlying lung . Within this limitation , a small right apical pneumothorax remains visible . The patient 's known pneumomediastinum is not significantly changed from prior studies . Opacification of the right middle lobe is unchanged , reflecting a component of collapse . No large pleural effusion is seen . The cardiomediastinal and hilar contours appear within normal limits .
    OUTPUT:
    
1 . Persistent small right apical pneumothorax . 2 . Extensive subcutaneous emphysema and pneumomediastinum , similar to prior studies .