Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left - sided chest tube is in place . When compared to the films from ___ and ___ , there appears to have been progressive retraction of the tip of the left chest tube , moving closer to the left chest wall . There is background COPD with hyperinflation , parenchymal scarring , and prominent areas of hyperlucency in both lung apices / upper zones , in the right lung laterally , and at the right lung base . There is probable bullous change at both apices . In the setting , it would be difficult to exclude a pneumothorax . Nonetheless , there is curvilinear lucency around the periphery of the left upper zone medially and laterally , likely continuing into the left along apex , consistent with a small to moderate size pneumothorax . This is similar , but probably slightly larger , compared to ___ . Again seen is subcutaneous emphysema along the left upper and mid chest . No left - sided basilar pneumothorax is detected . Of note , however , though there is opacity at the left lung base consistent with a small to moderate effusion and underlying collapse and / or consolidation , new compared with ___ , though similar to ___ . In addition , the left hemidiaphragm is elevated , but unchanged . Incidental note is made of clips in the right upper quadrant and soft tissue anchors over the right shoulder .
    OUTPUT:
    
1 . Left chest tube has progressively retracted toward the left chest wall , compared with ___ and ___ . The side port remains at over the lung itself . 2 . Small to moderate left pneumothorax seen in the upper left lung , best appreciated medially and laterally , similar , but possibly slightly larger than on ___ . 3 . Small left effusion , with underlying collapse under consolidation that has progressed compared with ___ . Elevated left hemidiaphragm again noted . 4 . Hyperlucency in the right upper , right mid lateral , and right lower zones . This may very well represent relate to background COPD . Background parenchymal distortion scarring related to COPD is also suggested .