CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 64-year-old male with
a history of non-Hodgkin's lymphoma diagnosed in [**2126**] status
post autologous bone marrow transplant in [**2130-11-25**];
status post recent admission in [**2131-6-13**] for community-
acquired pneumonia, now transferred from [**Hospital6 14430**].  The patient had onset of mild low back pain in mid
[**Month (only) 116**].  On [**2131-6-16**], he had the onset of severe low back pain
and went to the [**Hospital1 1474**] ED where he was treated and
released.  Next day, he had worsening pain, urinary
retention, and leg numbness.  MRI showed T10-T11 cord
compression and on [**2131-6-19**], he was transferred to [**Hospital1 2177**] for
laminectomy.  Pathology was positive for a lymphoma.  Since
the operation, his leg strength has improved; although, he
still needs a walker.  He is still having urinary retention.
He is still continuing to have some nocturnal back pain
radiating to his chest, described as dull pressure [**6-4**].

MEDICAL HISTORY: 1. Non-Hodgkin's lymphoma, stage 4 follicular center cell
   grade 1, diagnosed in [**2126**] status post CVP; achieved
   complete remission until [**2129**], then it transformed to
   large cell lymphoma with mesenteric involvement status
   post CHOP times 6 cycles and status post auto-BMT in
   [**2130-11-25**].  He is also status post Zevalin in [**Month (only) **]
   [**2130**].
2. History of pneumonitis status post transplant.
3. History of community acquired pneumonia treated with
   Levaquin in [**2131-5-26**] and cefpodoxime for 14 days.
4. Status post hernia repair.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: Former truck driver, widowed with 2
children, no alcohol, prior 25-pack-year tobacco history.
Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Retention of urine, unspecified,Complications of transplanted bone marrow,Pneumonia, organism unspecified,Acute respiratory failure,Acute kidney failure, unspecified,Myelopathy in other diseases classified elsewhere
Oth lymp unsp xtrndl org,Retention urine NOS,Compl marrow transplant,Pneumonia, organism NOS,Acute respiratry failure,Acute kidney failure NOS,Myelopathy in oth dis
Admission Date: [**2131-7-4**]        Discharge Date: [**2131-7-11**]

Date of Birth:  [**2066-8-15**]        Sex:

Service:  BMT


HISTORY OF PRESENT ILLNESS:  This is a 64-year-old male with
a history of non-Hodgkin's lymphoma diagnosed in [**2126**] status
post autologous bone marrow transplant in [**2130-11-25**];
status post recent admission in [**2131-6-13**] for community-
acquired pneumonia, now transferred from [**Hospital6 14430**].  The patient had onset of mild low back pain in mid
[**Month (only) 116**].  On [**2131-6-16**], he had the onset of severe low back pain
and went to the [**Hospital1 1474**] ED where he was treated and
released.  Next day, he had worsening pain, urinary
retention, and leg numbness.  MRI showed T10-T11 cord
compression and on [**2131-6-19**], he was transferred to [**Hospital1 2177**] for
laminectomy.  Pathology was positive for a lymphoma.  Since
the operation, his leg strength has improved; although, he
still needs a walker.  He is still having urinary retention.
He is still continuing to have some nocturnal back pain
radiating to his chest, described as dull pressure [**6-4**].

PAST MEDICAL HISTORY:
1. Non-Hodgkin's lymphoma, stage 4 follicular center cell
   grade 1, diagnosed in [**2126**] status post CVP; achieved
   complete remission until [**2129**], then it transformed to
   large cell lymphoma with mesenteric involvement status
   post CHOP times 6 cycles and status post auto-BMT in
   [**2130-11-25**].  He is also status post Zevalin in [**Month (only) **]
   [**2130**].
2. History of pneumonitis status post transplant.
3. History of community acquired pneumonia treated with
   Levaquin in [**2131-5-26**] and cefpodoxime for 14 days.
4. Status post hernia repair.


ALLERGIES:  No known drug allergies.

MEDICATIONS ON TRANSFER:
1. Colace 100 mg b.i.d.
2. Terazosin.
3. Percocet.
4. Ambien.
5. Protonix.
6. Dexamethasone 4 mg b.i.d.
7. Dulcolax.


FAMILY HISTORY:  Noncontributory.

SOCIAL HISTORY:  Former truck driver, widowed with 2
children, no alcohol, prior 25-pack-year tobacco history.

PHYSICAL EXAMINATION:  Temperature 99.8 degrees, blood
pressure 133/86, heart rate 101, respiratory rate 16.  In
general, he is in no acute distress.  Head, neck, cardiac,
pulmonary, abdominal exams were normal.  Extremity exam
showed trace edema.  Neurologic exam revealed full strength
except 4 plus out of 5 left knee flexion.  Sensory exam was
normal.  Deep tendon reflexes were 1 plus in the upper
extremities, trace at the knee on the left; absent at the
knee on the right with down going toes.

LABORATORY DATA:  Biopsy at the outside hospital showed 80 to
90 percent large lymphoid cells and flow cytometry was
consistent with lymphoma.

IMPRESSION:  This is a 64-year-old man with a history of non-
Hodgkin's lymphoma status post auto-BMT in [**2130-11-25**];
admitted to outside hospital with cord compression now status
post laminectomy secondary to transformed mantle cell
lymphoma.

HOSPITAL COURSE:  The patient was emergently started on DHAP
chemotherapy which he tolerated well; although, he did have
significant tumor lysis, LDH peaked at 9 to 10 thousand,
phosphate was elevated and uric acid was controlled with
allopurinol.  On [**2131-7-6**] and [**2131-7-7**], the patient had
increasing O2 requirement and on the afternoon of  [**2131-7-7**]
at approximately 4 p.m., he acutely desaturated and had
decreased blood pressure in the setting of Lasix; in addition
to spiking a temperature to 102 and he was transferred to the
Sennard ICU for further care.  In the ICU, the etiology of
his pulmonary infiltrates and hypoxemia was unclear,
infectious including fungal, PCP, [**Name10 (NameIs) **] bacterial versus CHF.
He was started on voriconazole; azithromycin, cefepime, and
vancomycin were continued.  Echocardiogram showed severe
right ventricular global hypokinesis and mild left
ventricular dysfunction.  Additionally, he developed acute
non-oliguric renal failure and ATN likely secondary to a
combination of Lasix, chemotherapy medications, and decreased
blood pressure.

On [**2131-7-10**], he started having mental status changes and
paranoia.  By the morning of the [**2131-7-11**], he was only
responsive to painful stimuli.  After family meeting with the
ICU team and Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], it was decided to make the
patient comfort measures only and he was transferred back to
the BMT service.  The patient was treated with morphine and
Ativan as necessary for comfort.  At 10:25 p.m. on the night
of [**2131-7-11**], the patient was found with no respirations,
pulse and not responsive to painful stimuli.

DISCHARGE CONDITION:  Deceased.

DISCHARGE DIAGNOSES:
1. Relapse non-Hodgkin's lymphoma with cord compression.
2. Acute renal failure.
3. Hypoxemia.
4. Pulmonary infiltrates.
5. Tumor lysis syndrome.


DISCHARGE MEDICATIONS:  No discharge medications or followup
plans as the patient is deceased.



                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 36051**]

Dictated By:[**Last Name (NamePattern1) 49323**]
MEDQUIST36
D:  [**2131-12-6**] 13:30:01
T:  [**2131-12-7**] 14:52:12
Job#:  [**Job Number 49324**]
{'Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Retention of urine, unspecified,Complications of transplanted bone marrow,Pneumonia, organism unspecified,Acute respiratory failure,Acute kidney failure, unspecified,Myelopathy in other diseases classified elsewhere'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: This is a 64-year-old male with
a history of non-Hodgkin's lymphoma diagnosed in [**2126**] status
post autologous bone marrow transplant in [**2130-11-25**];
status post recent admission in [**2131-6-13**] for community-
acquired pneumonia, now transferred from [**Hospital6 14430**].  The patient had onset of mild low back pain in mid
[**Month (only) 116**].  On [**2131-6-16**], he had the onset of severe low back pain
and went to the [**Hospital1 1474**] ED where he was treated and
released.  Next day, he had worsening pain, urinary
retention, and leg numbness.  MRI showed T10-T11 cord
compression and on [**2131-6-19**], he was transferred to [**Hospital1 2177**] for
laminectomy.  Pathology was positive for a lymphoma.  Since
the operation, his leg strength has improved; although, he
still needs a walker.  He is still having urinary retention.
He is still continuing to have some nocturnal back pain
radiating to his chest, described as dull pressure [**6-4**].

MEDICAL HISTORY: 1. Non-Hodgkin's lymphoma, stage 4 follicular center cell
   grade 1, diagnosed in [**2126**] status post CVP; achieved
   complete remission until [**2129**], then it transformed to
   large cell lymphoma with mesenteric involvement status
   post CHOP times 6 cycles and status post auto-BMT in
   [**2130-11-25**].  He is also status post Zevalin in [**Month (only) **]
   [**2130**].
2. History of pneumonitis status post transplant.
3. History of community acquired pneumonia treated with
   Levaquin in [**2131-5-26**] and cefpodoxime for 14 days.
4. Status post hernia repair.

MEDICATION ON ADMISSION: 

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: Noncontributory.

SOCIAL HISTORY: Former truck driver, widowed with 2
children, no alcohol, prior 25-pack-year tobacco history. 

### Response:
{'Other malignant lymphomas, unspecified site, extranodal and solid organ sites,Retention of urine, unspecified,Complications of transplanted bone marrow,Pneumonia, organism unspecified,Acute respiratory failure,Acute kidney failure, unspecified,Myelopathy in other diseases classified elsewhere'}
