Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the prior examination there has been interval re-development of a large left - sided pneumothorax with suggestion of tension and mild rightward displacement of the mediastinal structures . A left apical chest tube remains in place . There is extensive left - sided subcutaneous emphysema with tracking along the pectoralis . There is no right pneumothorax or pleural effusion . The cardiomediastinal and hilar contours are otherwise stable . There are no new focal occurring opacities concerning for pneumonia . Pulmonary vascularity is not increased .
    OUTPUT:
    
Interval re-development of large left - sided pneumothorax with associated signs of mild rightward mediastinal shift . Findings were discussed via telephone to Dr . ___ by Dr . ___ at 4 :05 p .m . on ___ .