a left basilar pleural pigtail catheter remains in place. however, on the current study, there is a small apical and medial hydropneumothorax best visualized on the lateral projection which is substantially smaller than that seen on <unk>. the lungs remain hyperinflated with stable parenchymal distortion and scarring consistent with underlying severe emphysema as evident on chest ct dated <unk>. a tiny left pleural effusion is stable. more focal patchy opacity in the left mid lung is unchanged but may reflect scarring related to underlying emphysema or superimposed infection. clinical correlation is recommended. no pulmonary edema. overall cardiac and mediastinal contours are stable.