Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable AP chest radiograph . The left - sided chest tube has been removed . Small left apical pneumothorax is new . Extensive subcutaneous emphysema is unchanged . Small amount of pneumomediastinum also is stable . The cardiomediastinal silhouette is normal . Left lower lobe opacity remains concerning for pneumonia .
    OUTPUT:
    
Small left apical pneumothorax after chest tube removal . No other significant interval change .