Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest demonstrate persistent large left - sided pneumothorax . Allowing for differences in technique , this pneumothorax appears to be slightly larger as compared to prior . There is rightward shift of the mediastinum consistent with tension pneumothorax . There are increased interstitial markings in bilateral lung fields . There is a moderate left - sided pleural effusion .
    OUTPUT:
    
Large left - sided pneumothorax with slight increase in size over the interval and rightward shift of the mediastinum , consistent with tension pneumothorax .