Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest . Chest tube is seen in the upper medial left hemithorax . There is a large left pneumothorax and moderate - sized left pleural effusion . No shift in mediastinal structures . The right lung is fully expanded and clear . There is no right pleural effusion . There is no right pneumothorax . The cardiac , mediastinal , and hilar contours are normal .
    OUTPUT:
    
New large left pneumothorax and moderate - sized left pleural effusion . There is no shift in the mediastinal structures . Left apical chest tube is in place . These findings were discussed with Dr . ___ at 4 :30 p .m . on ___ by telephone .