Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The large right pneumothorax has substantially increased despite the presence of a right pigtail catheter . There is a large amount of right chest wall subcutaneous emphysema and new pneumomediastinum . The left lung is clear . The heart and mediastinum are within normal limits despite the projection .
    OUTPUT:
    
Substantial interval increase in large right pneumothorax despite the presence of a right pigtail catheter . New pneumomediastinum .