Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: New extensive subcutaneous emphysema across the left chest wall extent superiorly into the neck and into the face . Improved left pleural effusion . Small left apical pneumothorax difficult to differentiate from overlying emphysema . Right lung is clear . Cardiac size is normal . Left chest tube in place .
    OUTPUT:
    
New extensive subcutaneous emphysema across the left chest wall and extending into the left neck and face and small left apical pneumothorax with left chest tube in place .