Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: open j tube placement bronchoscopy flexible and rigid, tumor destruction with mechanical debridement y stent placement bronchoscopy with aspiration of secretions esophagogastroduodenoscopy with attempted percutaneous endoscopic gastrostomy. direct laryngoscopy and esophagoscopy with biopsy history of present illness: mrs. is a 51 year-old female with a history of paroxysmal atrial fibrialltion, copd and increased shortness of breath. she was intubated on for respiratory distress. on bronchoscopy revealed a mass above the carina, extending onto the left mainstem bronchus. on resection of endobronchial tumor (yag laser) and endoscopy showing a ulcer at the ge junction. she was unable to be extubated and was transferrd from hospital for y stent placment of distal trachea and proximal mainstem bronchus. past medical history: pmh: afib, htn, etoh, copd, cad social history: lives at home alone,has never married.0.5-1 pack a day cigarettes for 30 years. alcohol 6 pack beer per day. family history: mother had breast cancer and pancreatic cancer,father also died of cancer. physical exam: general: 51 year-old female who appears older than stated age and cachexic heent: normocephalic, mucus membranes dry, neck: nontender diffuse fullness of r neck, no discrete lad palpable. no lad on l. trachea midline. cardiac: irregular, variable s1 and s2, no m/r/g, pmi lateral,precordium quiet resp: decreased breath sounds bibasilar crackles gi: bowel sounds positive, abdomen soft non-tender/non-distended peg in place, site clean, no erythema extr: warm no edema neuro: awake, alert & oriented pertinent results: wbc-6.4 rbc-2.75* hgb-9.6* hct-27.4 plt ct-161 wbc-10.1 rbc-3.21* hgb-11.2* hct-33.2 plt ct-383 glucose-74 urean-13 creat-0.4 na-145 k-3.6 cl-109* hco3-31 glucose-86 urean-10 creat-0.3* na-136 k-4.0 cl-102 hco3-30 tracheal tumor. pathology squamous cell carcinoma, invasive and moderately differentiated. procedure date tissue received report date diagnosed by dr. ,dr. . /tcc tracheal tumor. specimen submitted: biopsy right tonsillar fossa, additional right tonsil. diagnosis: i. right tonsillar fossa, biopsy (a-b): invasive squamous cell carcinoma, well to moderately differentiated, involving squamous mucosa; focal necrosis is identified. ii. right tonsil, additional tissue (c): invasive squamous cell carcinoma, well to moderately differentiated, involving squamous mucosa and adjacent skeletal muscle. fdg tumor imaging (pet-ct) interpretation: there is focal abnormal uptake of fdg in a right pharyngeal mucusal soft tissue mass measuring 2.2 x 2.8 cm, with an suv max of 11.8. there is no fdg-avid neck lymphadenopathy. there is another focus of marked fdg avidity (suv max 8.9) within the mediastinum, in the subcarinal region, approximatey 3.3 x 3.9 cm (including the carina, which is stented and patent). there are several additional mediastinal lymph nodes that are not fdg-avid. there is no fdg avid parenchymal lesion within the lungs. there is a moderate right and small left effusion. there is no abnormal fdg avid lesion within the abdomen and pelvis. note is made of dependent fluid layering in the presacral and perirectal space along with diffuse and dependent subcutaneous edema within the lower abdomen and pelvis. physiologic uptake is seen in the heart, liver, spleen, gi and gu tract. impression: 1. abnormal markedly fdg-avid subcarinal mass consistent with pathological diagnosis of squamous cell carcinoma. 2. no additional fdg-avid mediastinal, hilar, or lung lesions. 3. worrisome fdg avid right pharyngeal mass concerning for separate malignancy given patient's history and location. recommend direct visualization of this lesion. 4. dependent subcutaneous and perirectal/presacral edema. 5. bilateral pleural effusions. mr head w & w/o contrast 10:24 am findings: there is no evidence of mass, abnormal enhancement, hemorrhage, or abnormal signal intensity in the brain. the ventricles are within normal limits. the surrounding osseous and soft tissue structures are unremarkable with mild mucosal thickening in the ethmoid sinus and small amount of fluid in the mastoid air cells. there is no diffusion abnormality. the cystic lesion in the left mandible is partially included and shows low signal on t1 without ehhancement. impression: normal brain mri. no evidence of metastasis. mucosal thickening in ethmoid sinus and within the mastoid air cells. left mandibular cystic lesion. ct neck w/contrast (eg:parotids) 9:51 am neck ct with contrast: comparison was made with a prior pet ct dated . there is asymmetric soft tissue measuring approximately 2.5 x 2.0 cm in the right hypopharynx at the tonsillar pillar, corresponding to the fdg- avid mass, suspicious for neoplasm likely a primary tumor rather than metastasis. there is no significant mass or asymmetry in the nasopharynx. there is no significant lymphadenopathy. there is a 2 x 1 cm fluid-containing cystic lesion in the subcutaneous tissue anterior to the mandible. in the left internal jugular vein, there is tubular filling defect measuring 4 mm in diameter, and -30 . in the visualized portion of the lung apices, there are bilateral pleural effusion and patchy opacities in the lungs. there are degenerative changes of a cervical spine. impression: 1. soft tissue mass and asymmetric in the right hypopharynx, corresponding to fdg-avid tumor, suspicious for primary neoplasm such as squamous cell carcinoma. direct visualization and biopsy is recommended. 2. 2 x 1 cm fluid-containing cystic lesion anterior to the left mandible. physical examination is recommended. 3. hypodense tubular small filling defect in the left internal jugular vein. the hounsfield unit is somewhat too low for thrombus or turbulent flow, however, if clinically indicated, please perform ultrasound for further evaluation. 4. bilateral pleural effusion and patchy opacities in the apices. mucous secretion in trachea. ct chest w/contrast 3:56 pm findings: there is a conglomerate nodal mass centered at the level of the carina, extending superiorly to the level of the aortic arch and inferiorly to the azygoesophageal recess. this lesion encases the mainstem bronchi with extension peripherally to the hilar regions, with possible encasement of the upper and lower lobe bronchi. although this mass encases the central airways, there is no evidence of significant airway narrowing or endobronchial lesion. y-stent is seen in the trachea, with a small focus of extraluminal gas lateral to the trachea at approximately the level of the aortic arch. this may represent a localized perforation. no evidence of diffuse mediastinal gas. moderate-sized bilateral pleural effusions are seen, with atelectasis of the adjacent lung parenchyma. this is more severe on the left compared to the right. additionally, multifocal areas of peribronchiolar ground- glass opacities are also present, which may be infectious, inflammatory, or related to aspiration. compared to pet/ct , these ground- glass opacities are slightly improved. mild paraseptal and centrilobular emphysema. a small pericardial effusion is seen. otherwise, the heart and great vessels are unremarkable. impression: 1. large conglomerate nodal mass with its epicenter at the level of the carina, encasing the central airways. given possible hypopharyngeal primary malignancy identified on pet/ct, this conglomerate nodal mass may represent a metastatic site. 2. focal small extraluminal gas collection lateral to the trachea at site of stent. this may represent a small localized/contained perforation. 3. moderate bilateral pleural effusions with atelectasis of adjacent lung parenchyma. 4. multifocal areas of subtle peribronchiolar ground-glass opacities, may be infectious or inflammatory (e.g. aspiration). 5. free intraperitoneal air, likely related to recent peg tube placement. 10:18pm pt-12.9 ptt-23.3 inr(pt)-1.1 10:18pm plt count-161 10:18pm neuts-80.6* lymphs-16.5* monos-2.5 eos-0.4 basos-0 10:18pm neuts-80.6* lymphs-16.5* monos-2.5 eos-0.4 basos-0 10:18pm wbc-6.4 rbc-2.75* hgb-9.6* hct-27.4* mcv-100* mch-34.8* mchc-34.9 rdw-14.0 10:18pm calcium-8.3* phosphate-3.8 magnesium-2.1 10:18pm estgfr-using this 10:18pm estgfr-using this 10:18pm glucose-74 urea n-13 creat-0.4 sodium-145 potassium-3.6 chloride-109* total co2-31 anion gap-9 10:18pm glucose-74 urea n-13 creat-0.4 sodium-145 potassium-3.6 chloride-109* total co2-31 anion gap-9 brief hospital course: 50 yo f with past h/o paroxyoxysmal afib & copd admitted on to hospital for sob.during her admission afib was complicated by what was thought to be a severe copd exacerbation. they did an xray chest which showed b/l ll infiltrates.the ct scan revelaed l endobronchial narrowing, mediastinal abnormalities, extensive compression of the left main stem bronchus and the esophagus.the patient continued to have worsening respiatory status and had to placed in bipap,her ph at this time was 7.33 but pco2 had gone upto 82. on she continued to have hypercapneic respiratory insufficiency and had to be intubated.a bronchoscopy followed demonstrating a mass above the carina,extending into the left mainstem bronchus.the right side was clear.biopsies were taken from the area which showed non small cell lung cancer.on she got a yag laser resection of the endobronchial tumor with resultant opening of 40% of the l main stem bronchus.she also got an endoscopy which showed a benign appearing ulcer at the ge junction.no tumor was seen.a trial for extubation was made on but she could not last too long of the breathing machine. she was then transferred to for stent placement of distal trachea and proximal mainstem bronchus. she received this y-stent without any adverse sequelae. multiple trials with extubation were not successful, but the patient was eventually able to extubate, leave the icu care setting, and transfer to the floor. as she remained on the hospital surgical floor, the patient's heart rate had been a chronic issue of management, but was kept under the control with the assistance of cardiology consultants. the surgical team was concerned about her nutritional status; as such a j tube was placed surgically with good success. the patient was able to tolerate tube feeds at goal nutritional status (evaluated jointly between the primary team and nutritionists) and manage the basic care of her j tube. at the time of discharge the patient's nutritional status is improving, and her heart rate is well-controlled on her current cardiac medical regimen. there are no lingering surgical issues at this time, and the patient's y-stent has functioned appropriately at this time. medications on admission: meds upon transfer: diltiazem 5mg/hr iv propofol 20-50 mcg/kg/min potassium chloride 20mcg/1000ml fentanyl citrate 25-1000mcg/hr flucanazole 100mg iv once chlorhexidine 0.12% pantoprazole 40 mg q24h methylprednisone sodium succinate 10 mg iv q24h albuterol- ipratropium 8 puff q4h heparin 5000 unit sc tid fluticasone propionate 110 mcg. discharge medications: 1. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 2. fluticasone 110 mcg/actuation aerosol sig: four (4) puff inhalation (2 times a day). 3. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for copd. 4. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): via j-tube. 5. diltiazem hcl 90 mg tablet sig: one (1) tablet po qid (4 times a day) as needed for afib: via j-tube. 6. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily): via j-tube. 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for afib: all meds via j-tube. 8. pepcid 40 mg/5 ml suspension sig: five (5) mls po once a day. 9. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily): via j-tube. 10. guaifenesin 100 mg/5 ml liquid sig: twenty (20) mls po q4h (every 4 hours) as needed for stent maintenance: via j-tube must stay on for life of silicone stent- not prn. 11. loperamide 2 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for loose bm: via j-tube. 12. combivent 18-103 mcg/actuation aerosol sig: one (1) inhalation four times a day. 13. tube feed tubefeeding: nutren pulmonary full strength; goal rate:45 ml/hr flush w/ 50 ml water q8h discharge disposition: extended care facility: rehab and nursing center discharge diagnosis: lung cancer squamous cell pharyngeal cancer atrial fibrillation coronary artery disease s/ mi c/b vf age 32 & 42 chronic systolic dysfunction hyperlipidemia hypertension copd breast cancer s/p lumpectomy discharge condition: deconditioned- awaiting chemotherapy and radiation. discharge instructions: call dr. office if you experience chest pain, shortness of breath, fever, chills, nausea, vomiting, diarrhea, or abd pain. strict npo- wilent aspiration if your feeding tube sutures become loose or break, please tape tube securely and call dr. office . if your feeding tube falls out, save the tube, call the office immediately . the tube needs to be replaced in a timely manner because the tract will close within a few hours. do not put any medication down the tube unless they are in liquid form. flush your feeding tube with 50cc every 8 hours and before and after every feeding. follow up with oncology and radiation oncology to begin treatment. followup instructions: follow-up with dr. pcp follow-up with dr. follow-up with dr. radiation oncologist follow-up with dr. md procedure: other endoscopy of small intestine other esophagoscopy enteral infusion of concentrated nutritional substances other bronchoscopy other bronchoscopy arterial catheterization other intubation of respiratory tract other intubation of respiratory tract laryngoscopy and other tracheoscopy endoscopic excision or destruction of lesion or tissue of bronchus pharyngeal biopsy diagnoses: other primary cardiomyopathies coronary atherosclerosis of native coronary artery congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of breast percutaneous transluminal coronary angioplasty status chronic systolic heart failure pressure ulcer, buttock malignant neoplasm of other parts of bronchus or lung secondary malignant neoplasm of lung other diseases of trachea and bronchus nutritional marasmus malignant neoplasm of other specified sites of oropharynx 

Answer: The patient is high likely exposed to