Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: On the left , again seen is extensive subcutaneous emphysema . The presence of a tiny left apical pneumothorax would be difficult to exclude . Left - sided chest tube and pigtail catheter again noted , similar in configuration . Streaky vertical linear lucency along the left heart border is again noted . The cardiomediastinal silhouette itself appears unchanged . Small metallic densities superimposed over left heart are consistent with endobronchial valves . On the right , lung borders are difficult to delineate . There is suspicion for a a small right apical pneumothorax . There is also diffuse hyper lucency in the right lung . The possibility of a more extensive a right - sided pneumothorax can not be excluded . However , is possible that this is predominately due to background emphysematous change . Small ovoid band of density in the right mid zone could represent a small amount of fluid in the minor fissure . Minimal patchy opacity in the right cardiophrenic region --___ atelectasis or scarring . Mild fullness of central and upper zone vasculature , unchanged , without overt CHF . No gross effusion .
    OUTPUT:
    
Extensive left - sided subcutaneous emphysema again seen . Chest tubes in unchanged configuration . Possible small left apical pneumothorax . Linear lucencies along left heart border -- ___ pneumomediastinum versus pneumothorax deep to the medial side of the lung . Possibility of a small amount of air extending from subcutaneous emphysema seen about the neck of the cause for pneumo mediastinal air can not be excluded . Suspect small right apical pneumothorax . More diffuse hyper lucency in the right lung could be due to emphysematous change , though the possibility of an occult pneumothorax outside of the right apex can not be excluded . Probable small amount of fluid in the minor fissure .