Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A small - moderate size right apical pneumothorax is again noted . No associated mediastinal shift is seen . The lungs are clear without focal consolidation or pleural effusion . The heart size is normal . A spinal stimulator device is noted .
    OUTPUT:
    
Similar small - moderate right apical pneumothorax without mediastinal shift .