Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A chest tube projects over the mid to upper right lung . The previously identified small right apical pneumothorax appears unchanged to minimally decreased in size . Extensive subcutaneous emphysema involving the lateral right and upper left chest wall is unchanged . The lungs are otherwise clear . No pleural effusion . Heart size is normal . Cardiomediastinal and hilar silhouettes are normal .
    OUTPUT:
    
Essentially unchanged to minimally decreased right apical pneumothorax . Otherwise unchanged examination .