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: percodan attending: chief complaint: need for possible esophageal and y-stent placement major surgical or invasive procedure: radiation therapy to lung mass history of present illness: mr. is a 69 year-old man with copd and newly diagnosed right lower lobe poorly differentiated nsclc w/ bulky mediastinal lymphadenopathy and obstruction of the esophagus and distal trachea and bilateral mainstem bronchi. he was initially transferred to the micu from hospital after being admitted on for evaluation for esophageal and y-stent placement for compressive lung mass. vs on arrival were t 97.0, bp 130/60, hr 110, rr 24 with sat 94 on 10lnc. about two months ago, he presented with hemoptysis and, with the workup, ultimatley had a biopsy around 3 weeks ago. he has lost 35 lbs due to anorexia and difficulty getting food down. he had a peg tube placed on . mri head at osh was negative for mets. he was managed with duonebs, iv solumedrol and azithromycin at the osh, though his respiratory status continued to decline. in the micu, he was started empirically on vanc/unasyn for aspiration pneumonia and seen by ip. they felt that his hypoxia was most likely secondary to right pulmonary artery compression from the mediastinal mass/lad, and did not feel that he would benefit from y-stent placement. however, if one were placed, they recommended evaluation for simultaneous esophageal stent placement. they also recommended chest cta to rule out pe (he previously had chest ct with contrast at osh but was not protocoled for pe per report), and urgent rad onc consult. he is transferred to the today for initiation of radiation simulation and with first session of xrt to begin this afternoon. vitals immediately prior to transfer were 97.3 99-110 20 147/62 95%nrb, up from 10l nasal canula on arrival to the micu. ros is notable for dyspnea, back pain, headache, occ cough. it is negative for fc, abd pain, change in bm. past medical history: -peg tube placed on -copd -htn -transitional cell bladder ca -spermatic cord liposarcoma, , rp nodal resection; no chemo/xrt -poorly differentiated nsclc -- rll; needle bx -cholecystectomy social history: 50 pack year smoking history; drinks 1 drink per day; prior asbestos exposure. no ivdu. family history: mother-- breast ca; father-- diabetes physical exam: vs on arrival were t 97.0, bp 130/60, hr 110, rr 24 with sat 94 on 10lnc general: appears somewhat uncomfortable with face mask but nad heent: bearded, conjunctiva nonicteric, op clear lungs: rhonchorous esp at right base; wheezing throughout cardio: tachycardic, rate regular, no murmurs appreciated abd: + bs, soft, ntnd ext: no , wwp skin: no rashes, no petechiae neuro: aa, ox3, cn ii - xii normal; strength 5/5 throughout pertinent results: admission labs: 07:24pm blood wbc-22.2* rbc-3.77* hgb-11.4* hct-33.3* mcv-88 mch-30.3 mchc-34.3 rdw-13.2 plt ct-313 07:24pm blood neuts-94.6* lymphs-3.0* monos-2.3 eos-0.1 baso-0.1 07:24pm blood pt-13.3 ptt-24.9 inr(pt)-1.1 07:24pm blood glucose-203* urean-22* creat-0.6 na-136 k-4.4 cl-100 hco3-24 angap-16 07:24pm blood calcium-9.2 phos-3.0 mg-2.1 chest ct : impression: 1. extensive mediastinal, hilar lymphadenopathy involving the entire mediastinum and hila bilaterally, with minimal change within the right hilum compared to prior study. the lymphadenopathy encases aorta, right main pulmonary artery and svc as described in details in the body of the report. interval increase in pericardial effusion is noted, small-to-moderate. 2. right lower lobe mass, unchanged. 3. bilateral pleural effusion, unchanged. 4. large right adrenal mass, no comparison with prior studies is available and this area was not included on the prior outside study. 5. multiple mesenteric lymph nodes most likely representing a similar process. 6. hypodense pancreatic lesion, significance is unknown, might represent ipmn or involvement of the pancreas by metastatic process as well. 7. status post peg insertion due to significant compromise of the esophagus by lymphadenopathy. 8. metastasis involvement of l1 by lytic lesion with soft tissue component. no involvement of posterior endplate and spinal canal is seen at this point. brief hospital course: 69 y/o gentleman with rll nsclc and extensive mediastinal lymphadenopathy that is compressing the esophagus, left lower lobe segmental bronchi, and right pulmonary artery; he was admitted to the while he completed his radiation course. the patient did develop atrial fibrillation and rapid ventricular rate that was controlled with metoprolol. problem list: #. /hypoxia: new diagnosis of lung cancer with involvement of mediastinum and compression of right pulmonary artery, distal trachea, bilateral mainstem bronchi, and esophagus. transferred to for expedited xrt and monitoring during therapy. hypoxia likely multifactorial with right pulmonary artery compression, ? of post-obstructive pneumonia, and airway compression. pt was given 5 days of xrt to fairly wide area in chest. after few days started having difficulty with substernal chest pain likely to mass effect and post-radiation changes/inflammation. he was also treated with a 7 day course of vanc/unasyn for emperic coverage of post-obstructive pna. all micro culture was negative. dnr/dni status was established at initial presentation. a palliative care consult was obtained due to the nature of the disease process. pain control recs were left and followed and a discussion was started about long term plans. family expressed interest in having pt with son in area with home hospice. pt expressing interest in going home to . dr. office called to schedule f/u appointment in case pt stays in area on d/c. #. pain, right chest, tumor-related: fentanyl patch, as needed morphine. #. atrial fibrillation: pt with new onset of afib during the evening of . also with rvr tachy to 150s. ekg showed no signs ischemia. 5mg of iv metoprolol x 2 slowed rate to 110-120s but not further and bp bottomed to 90s/60s. metoprolol was changed to qid. hr slowly increased again to 150s over next hrs but pt spontaneously convereted to sinus early in am with no further intervention. it is thought that a combination of atrial compression from the mass and radiation change to the atrial area precipitated the afib which did not reoccur while in the . discharged on metoprolol 50mg po q8hrs. recommend increasing to 50mg po q6hrs if patient has recurrent rapid ventricular response. #. rue swelling/erythema: noted on . concern for dvt or svc syndrome as come evidence of svc compression on chest ct. u/s rue showed occlusive clot of cephalic vein (superficial vein) but no dvt. #. copd: initially treated for copd exacerbation at osh with azithro and solumedrol. pt was kept on standing ipratropium/albuterol + prn albuterol for sob but steroids were discontinued per rad onc request while on xrt. #. back pain: history of distant back surgery and patient reports chronic back pain x decades, no worsening in last several months. rad onc okayed nsaids during therapy so high dose ibuprofen was started in addition to standing opiods. #. htn: on metoprolol mostly for rate control. #. dvt prophylaxis: heparin subcutaneous #. code status: dnr/dni #. communication: (son) medications on admission: atenolol 25mg po daily vicodin pravachol 40mg daily discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 3. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization : one (1) unit dose inhalation q4h (every 4 hours) as needed for sob. 4. lorazepam 0.5 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for anxiety. 5. benzonatate 100 mg capsule : one (1) capsule po tid (3 times a day). 6. fexofenadine 60 mg tablet : one (1) tablet po bid (2 times a day). 7. fluticasone 50 mcg/actuation spray, suspension : two (2) spray nasal daily (daily). 8. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) unit injection tid (3 times a day): for dvt prophylaxis. 9. morphine 10 mg/5 ml solution : five (5) mg po q4h (every 4 hours) as needed for pain. 10. acetaminophen 650 mg/20.3 ml solution : six y (650) mg po q6h (every 6 hours) as needed for fever or pain. 11. ipratropium bromide 0.02 % solution : one (1) unit dose inhalation q6h (every 6 hours) as needed for wheezing. 12. fentanyl 12 mcg/hr patch 72 hr : one (1) patch 72 hr transdermal q72h (every 72 hours). 13. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 14. trazodone 50 mg tablet : 0.5 tablet po hs (at bedtime) as needed for insomnia: repeat x1 as needed. 15. metoprolol tartrate 50 mg tablet : one (1) tablet po tid (3 times a day): hold for sbp<90 or hr<60. discharge disposition: extended care facility: care center - discharge diagnosis: primary diagnoses: - non small cell lung cancer - atrial fibrillation - hypoxemia - pain, right chest, tumor-related secondary diagnoses: - g-tube placed - chronic obstructive pulmonary disease - hypertension - transitional cell cancer of the bladder - spermatic cord liposarcoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you were managed at the with radiation therapy for your lung cancer. you developed complication with an irregular heart rhythm called atrial fibrillation that is controlled with a medication called metoprolol. we decided to leave in the gastric tube that you use for supplemental tube feeding because it may be useful for medicine administration and food supplementation and because you did not mind having it left in. you will transition to a skilled nursing facility to continue receiving care and support for your medical issues. followup instructions: dr - pulmonary clinic - please call after tuesday to make appointment as desired. procedure: enteral infusion of concentrated nutritional substances other radiotherapeutic procedure diagnoses: other chronic pain unspecified essential hypertension atrial fibrillation peripheral vascular disease, unspecified other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus compression of vein other emphysema personal history of malignant neoplasm of bladder personal history of malignant neoplasm of testis encounter for palliative care enlargement of lymph nodes backache, unspecified malignant neoplasm of lower lobe, bronchus or lung secondary malignant neoplasm of bone and bone marrow stricture and stenosis of esophagus gastrostomy status volume depletion, unspecified other diseases of trachea and bronchus dysphagia, unspecified acute venous embolism and thrombosis of superficial veins of upper extremity 

Answer: The patient is high likely exposed to