Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal radiograph of the chest demonstrates interval exchange of a left - sided pleural catheter with large apical pneumothorax extending to at least the level of the fifth rib . There is no appreciable mediastinal shift . The previously seen left - sided Port - a - Cath and esophageal stent remain in unchanged standard position . The previously seen right pleural effusion is similar in appearance to prior study . The cardiomediastinal silhouette is unchanged .
    OUTPUT:
    
Left pleural catheter exchanged with associated large left apical pneumothorax . The above findings were communicated to Dr . ___ by Dr . ___ ___ telephone at ___ , five minutes after discovery was made .