Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The large right apical lateral pneumothorax persists and is overall unchanged since the prior exam , now with a uppermost portion of aerated lung projecting over the fifth posterior right rib . Associated relaxation atelectasis , particularly of the right lower lobe is overall unchanged . The right pigtail catheter projects over the right lower hemithorax at the costophrenic angle , unchanged . Small right pleural effusion is new . No change in the appearance of the left lung , including no effusion , pneumothorax , or focal consolidation . No edema . Heart is normal in size . Mediastinum is not widened . Anterior cervical vertebral fixation hardware is noted .
    OUTPUT:
    
1 . No significant interval decrease in the size of the right large apical lateral pneumothorax . Consideration of placing a larger chest tube is recommended . 2 . New small right pleural effusion .