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: rapid afib, pulmonary embolus, dyspnea major surgical or invasive procedure: expired history of present illness: this is a 73 yo f with a past medical history significant for nsclc s/p resection, in remission for 5 years, and marked copd, who presents to the ed after experiencing progressive dyspnea over the last several weeks, requiring oxygen therapy around the clock rather than just with exertion. in the ed she was found to be in afib (new for this patient) with rvr to 170's. she was sent for cta and was found to have a small subsegmental pe and was started on a heparin gtt. she was given a dose of levofloxacin for ?infectious process given leukocytosis on cbc to 26 and she was initiated on a dilt gtt after two doses of iv dilt did not affect her hr that much. she also notes swelling in her legs bilaterally and her left arm, as well as a new mass in the left side of her neck which per the patient grew in entirety over the last two weeks. of note, she also had knowledge of a breast mass, which had not yet been worked up. last mammogram seems to be in . per the patient's pcp , "she has adamantly refused all screening and followup testing at this time. we discussed follow up chest x-rays and ct scans for example and also mammograms, but she refuses that. she refuses colon cancer screening. at this point, she feels that she would not accept or take any further medications or any further therapies for any further diseases." she is admitted to the micu for further evaluation of her afib with rvr and dyspnea. currently in the micu, the patient is hemodynamically stable with a hr in the 140's-150's. she is breathless on supplemental o2. she denies fevers/chills, n/v or nightsweats. she admits to some weight loss, and although does not entertain palpitations, she felt something was wrong and attributed it to her chronic anxiety. she denies calf tenderness, chest or abdominal pain. she is refusing blood draws and foley catheter. past medical history: status post stage iii lung cancer s/p left upper lobe lobectomy, with chemo/rads copd glaucoma major depressive disorder anxiety social history: 2 ppd x 40 years, just quit several months ago. was real estate , frequently travels to for vaction. has two daughters, one is in who is hcp. family history: non-contributory physical exam: vs: temp: 97.6 bp:146/72 hr: 137 rr: 13 o2sat 99% on 4l nc gen: cachectic, comfortable, nad but breathless when talking heent: perrl, eomi, but right strabismus and left eyelid ptosis, anicteric, mm dry, op without lesions. dentures in place. neck: large left sided nontender, nonmobile hard mass just lateral to the thyroid, no jvd, no carotid bruits. rij in place. resp: no breath sounds at the right base. scattered crackles and +expiratory wheeze with prolonged e:i ratio. cv: tachcardic and irregularly irregular. no murmurs. abd: nd, +b/s, soft, nt, no masses or hepatosplenomegaly ext: nonpitting 2+ edema in the ext bilaterally, right ue with 1+ nonpitting edema. warm, good pulses skin: no rashes/no jaundice neuro: aaox3. cn ii-xii intact. 4/5 strength throughout (generally weak). no sensory deficits to light touch appreciated. essential tremor present. dtr's normoreflexive. breast exam refused. pertinent results: 11:20am wbc-25.3*# rbc-4.01* hgb-12.1 hct-38.9 mcv-97 mch-30.2 mchc-31.1 rdw-14.4 neuts-96.4* bands-0 lymphs-1.4* monos-1.6* eos-0.5 basos-0 11:20am glucose-212* urea n-24* creat-0.8 sodium-141 potassium-4.5 chloride-98 total co2-29 anion gap-19 11:20am calcium-8.9 phosphate-3.8 magnesium-2.0 ekg: afib with rvr to 170's. cxr: 1. hazy opacity in the right lung base may represent a layering pleural effusion, although pneumonia cannot be excluded; a lateral view is recommended. 2. stable emphysematous changes and volume loss on the left related to left upper lobectomy. cta chest: 1. right lower lobe subsegmental pulmonary embolism. no evidence of compression of the svc. 2. moderate-to-severe emphysema with interstitial septal thickening consistent with underlying chf. small left greater than right pleural effusions, with atelectasis in the right lower lobe. 3. status post left upper lobectomy with stable left volume loss and post-radiation changes. 4. interval development of hypodense mass likely arising from the left lobe of the thyroid. two left upper quadrant soft tissue masses. multiple mediastinal and hilar lymph nodes as described above. soft tissue nodule in the left breast and subcentimeter likely lymph node in the presternal soft tissues. given the patient's history of lung cancer, these findings are suspicious for malignancy. brief hospital course: 73 yo f with a past medical history of nsclc status-post chemo-radiation and right upper lobectomy admitted with progressive dyspnea in the setting of multiple new masses, new atrial fibrillation with rvr, and subsegmental pe. # dyspnea: etiologies for the patient's dyspnea include atrial fibrillation with rvr with decreased forward flow, progression of copd, interstitial lung disease secondary to radiation therapy, metastasis and infection. although she had a leukocytosis, and possible effusion at the right base, she was afebrile during her inpatient stay. she does have a very small subsegmental pe, which could have also contributed to dyspnea. was rate controlled with a esmolol drip. patient then became suddenly hypoxic with short duration asystole the afternoon of , thought to be secondary to possible mucous plugging. daughter was concerning the event and her mother's poor prognosis. at that time, she requested she be cmo. all medications were stopped and she was given morphine iv for comfort. she expired at 8:15pm on due to cardiopulmonary arrest. # afib with rvr: unclear if her known small subsegmental pe would actually cause the patient's afib with rvr. other possible causes could be dehydration in the setting of poor po intake/infection. also rapidly growing mass contiguous with the thyroid could be causing a relative thyroiditis, or be producing thyroid hormone itself. tsh was check and was low normal. rate was controlled with an esmolol drip until the events immediately preceding her death. # pulmonary embolus: known small subsegmental pe. thus, she was maintained on a heparin gtt. ed confirmed with oncology that it was okay to start heparin gtt without head imaging as long as initiated without a bolus. pe thought to be likely to tumor. heparin gtt was discontinued once patient was made cmo on . # neck mass: concerning for malignancy. patient had a breast mass noted on a mammogram from and has since refused follow up screening. concerned that this could represent a breast primary with metastases to her thyroid and mediastinal nodes. unclear what left upper quadrant masses are at this time. other possibility is recrudescence of nsclc, but this is unlikely although she continued to smoke until this year. with poor oral intake, fatigue and weight loss, malignancy was high on the differential. associated hoarseness could be secondary to recurrent laryngeal nerve compression. heme-onc was consulted and recommended obtaining tissue for a diagnosis. general surgery was consulted but determined she was too unstable during her stay for tissue biopsy. patient expired without clear diagnosis and family declined autopsy. # anxiety/depression: while inpatient was continued on antidepressants and ativan prn. # copd: this ongoing issue likely contributed to her overall respiratory distress while inpatient. she was treated with atrovent and albuterol was used only minimally secondary to concern for tachycardia. patient become increasingly dyspneic during the day of . at approximately 4pm, physicians were called to the bedside for pulselessness and respiratory arrest thought to be secondary to mucous plugging. was treated with atropine and epinephrine and subsequently regained a heart rhythm, blood pressure and pulse. pupils were noted to be unresponsive at that time. her family was notified of the acute change and poor prognosis and decided to make her cmo status. all medications were discontinued beyond those for comfort. patient expired on at 8:15pm secondary to cardiopulmonary arrest. medications on admission: trazadone buspar wellbutrin triazolam atrovent ppi veranicicline reglan tid discharge medications: expired discharge disposition: expired discharge diagnosis: primary: non-small cell lung cancer secondary: copd, neck mass discharge condition: expired discharge instructions: expired followup instructions: expired md procedure: venous catheterization, not elsewhere classified diagnoses: chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of bronchus and lung secondary malignant neoplasm of other specified sites personal history of tobacco use unspecified glaucoma hypotension, unspecified cardiac arrest major depressive affective disorder, single episode, unspecified surgical or other procedure not carried out because of patient's decision encounter for palliative care other pulmonary embolism and infarction secondary and unspecified malignant neoplasm of intrathoracic lymph nodes personal history of irradiation, presenting hazards to health leukocytosis, unspecified foreign body in larynx malignant neoplasm of breast (female), unspecified abdominal or pelvic swelling, mass, or lump, other specified site 

Answer: The patient is high likely exposed to