Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Single frontal view of the chest demonstrates persistent substantial subcutaneous soft tissue emphysema in the right lateral chest wall and deep cervical soft tissues . There is marked increase in pneumomediastinum and pneumopericardium , raising question of a large bronchopleural connection including the right upper lobe bronchial stump . A right basal approach chest tube terminates apically , stable in location . Previously seen right apical pneumothorax has decreased in size with a small residual apical pneumothorax . The heart is top normal in size . Dense retrocardiac opacity persists compatible with atelectasis . A moderate left pleural effusion is persistent .
    OUTPUT:
    
1 . Striking increased pneumomediastinum and pneumopericardium in the setting of persistent extensive subcutaneous emphysema , raise question of a large bronchopleural connection / fistula including the right upper lobe bronchial stump . 2 . Diminishing small right apical pneumothorax with stable chest tube . Findings reported to Dr . ___ at pager #___ at 11 :00 a .m . on ___ via phone by Dr . ___ at the time of discovery .