Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable semi supine chest radiograph ___ 04 : 13 is submitted .
    OUTPUT:
    
Again seen is extensive emphysema with prominent bullous changes particularly at the bases . However , there is increased lucency at the left base with slight elevation of the left hemidiaphragm as well as increasing infrahilar opacity . Findings therefore raise the possibility of a loculated pneumothorax . Followup imaging is recommended . Endotracheal tube has its tip approximately 6 cm above the carina . A left subclavian PICC line has its tip in the distal SVC near the cavoatrial junction and a nasogastric tube is seen coursing below the diaphragm with the tip not identified . No pulmonary edema .