Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Tracheostomy tube is unchanged in position . A right - sided PICC line is unchanged in position with the tip overlying the upper SVC . The moderate to large left pneumothorax has increased in size from the preceding chest radiographs , now with a basal component ( previously only apical ) . A left pleural effusion is decreased in size from the preceding study . Known emphysema is unchanged . The cardiac silhouette is top normal in size . The hilar and mediastinal contours are stable . A PEG tube is noted in the left upper abdomen . Large retrocardiac atelectasis is unchanged .
    OUTPUT:
    
Increased moderate to large left pneumothorax with decreased small left pleural effusion . Findings were discussed by Dr . ___ with Dr . ___ by phone at 4 :30 p .m . on ___ .