Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are hyperexpanded consistent with the provided history of chronic obstructive pulmonary disease . There are multiple bulla throughout both lungs , seen on multiple prior examinations and a chest CT examination from ___ . A moderate right apical and lateral pneumothorax is new since ___ . There is a small right pleural effusion . Bilateral patchy and linear opacities are relatively stable in appearance . No new focal opacity concerning for pneumonia . No left pleural effusion or pneumothorax . The cardiac and mediastinal contours are stable .
    OUTPUT:
    
New moderate right apical / lateral pneumothorax . Small right pleural effusion . No new focal opacity concerning for pneumonia .