Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A moderate size , predominantly basally located , right pneumothorax is noted with atelectasis of the right lung . There is no substantial leftward shift of mediastinal structures noted . Mild cardiomegaly is re - demonstrated with evidence of TAVR . Hilar contours are unchanged . Extensive fibrosis is seen within the lungs bilaterally as well as emphysema within the upper lobes , similar to that noted on the prior study . No pleural effusion is present . No pulmonary edema is clearly identified .
    OUTPUT:
    
Moderate - size , predominately basally located right pneumothorax without definite signs tension . Extensive chronic fibrotic changes within the lungs with marked emphysema in the upper lobes .