Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There has been interval development of a large left pneumothorax with the previously appreciated left apical lesion shifted downward to collapse with a fiducial marker projecting over its periphery . There is no mediastinal shift . The right lung is clear . There is no pleural effusion .
    OUTPUT:
    
Large left pneumothorax status post left apical lung lesion fiducial placement . Results were discussed over the telephone with Dr . ___ by ___ ___ at 15 : 20 on ___ at time of initial review .