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: ic mass lesion major surgical or invasive procedure: l craniotomy for resection of frontal mass history of present illness: is a 52 yo right handed man with no significant past medical history transferred here from hospital for evaluation of a brain mass. mr. states he had been in good health until approximately 10 days ago when he noted weakness in his right arm. he had difficulty writing, holding utensils to eat. he thought his weakness was related to the use of icy-hot on his right shoulder (treating chronic shoulder pain). however, he then noted difficulty walking, feeling as though his knees would buckle. he also noticed he was more likely to fall after having a drink in the evening. this progressed to the point that he sought evaluation today at his local ed. there, a ct of the head w/wo contrast identified a 3cm left frontal/parietal mass. he was referred here for further evaluation. the patient denies any headache, changes in vision, vertigo, nausea, or vomiting. he has a feeling of numbness over the right deltoid and his right face. he has chronic decreased appetite and notes slight weight loss over the past year. he denies fevers, chills, nightsweats, cough, abdominal pain, changes in bowels/urinary habits, hematachezia or or any other systemic symptom. past medical history: spontaneous sah ~4/5 years ago. no intervention. colonoscopy 5 years ago with removal of polyps. social history: works as a mechanic. lives in nh. smokes 1ppd >30 years. drinks 2 drinks per night (white russian), somkes marijuana on occasion. family history: father with cad, stroke mother with pancreatic cancer maternal gm with bone ca pgf with lung ca physical exam: t: 98.9 bp: 122/82 hr:84 r18 99% on ra o2sats gen: thin, comfortable, nad. heent: nontraumatic, neck supple. mmm lungs: cta with diminished airmovement at bases cardiac: rrr. s1/s2. abd: soft, nt, bs+ extrem: warm and well-perfused. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. recall: objects at 5 minutes. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, to mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue with right deviation. motor: normal bulk slightly increase tone bilateral le. no abnormal movements, tremors. d b t we wf ip q h at g r 4 4 5 5 5 4+ 5- 5 5 5 5 l 5 5 5 5 5 5 5 5 5 5 5 sensation: intact to light touch, propioception, pinprick and vibration bilaterally. reflexes: 3 throughout except right ankle with 6 beats of clonus, left with 2 beats. toes mute on right, down on left coordination: normal on finger-nose-finger on left (right not tested secondary to weakness), normal rapid alternating movements. gait limited by weakness but able to support weight. physical exam upon discharge ************* pertinent results: , m 52 cardiology report ecg study date of 2:30:54 pm sinus rhythm. poor r wave progression. no previous tracing available for comparison. tracing #1 read by: , k. intervals axes rate pr qrs qt/qtc p qrs t 83 172 78 362/402 75 13 59 display/print ecg (requires a software download) , m 52 radiology report chest (pa & lat) study date of 3:33 pm , eu 3:33 pm chest (pa & lat) clip # reason: eval for mass medical condition: 52 year old man with new head mass reason for this examination: eval for mass provisional findings impression: jbre fri 7:04 pm indication: 62-year-old man with new head mass. please evaluate for mass. technique: pa and lateral radiographs of the chest were obtained. comparison: ct of the head from an outside hospital scanned into the pacs system of at 10:30 on . findings: there is bilateral upper lobe increased lucency with still visible pulmonary vasculature and no evidence of pneumothorax. these findings are consistent with severe bilateral upper lobe emphysematous or bullous changes. right middle lobe plate-like atelectasis and mass-like parenchymal distortion in the left lingula might represent scarring or mass. the cardiomediastinal silhouette and hila are normal. there is no pleural pathology. there are no bony or soft tissue abnormalities. impression: 1. severe bilateral upper lobe emphysematous/bullous changes. 2. left lingula mass-like parenchymal distortion might represent scaring or neoplasm. ct might be considered for further workup if clinically indicated. final report indication: 62-year-old man with new head mass. please evaluate for mass. technique: pa and lateral radiographs of the chest were obtained. comparison: none. findings: there is bilateral upper lobe increased lucency with visible pulmonary vasculature and no evidence of pneumothorax. these findings are consistent with severe bilateral upper lobe emphysematous/bullous changes. right middle lobe plate-like atelectasis. large area of parenchymal distortion in the lingular lung might represent scarring, although underlying mass can not be excluded and is of concern. impression: 1. severe bilateral upper lobe emphysematous/bullous changes. 2. left lingula mass-like parenchymal distortion might represent scaring and/or neoplasm. chest ct recommended for further evaluation. the study and the report were reviewed by the staff radiologist. dr. dr. approved: sun 12:11 am imaging lab , m 52 radiology report ct abd w&w/o c study date of 12:04 pm , fa11 12:04 pm ct abd w&w/o c; ct pelvis w/contrast; ct chest w/contrast clip # reason: please assess for malignancy, staging. contrast: optiray amt: 130 medical condition: 52 year old man with brain mass, likely metastasis. also right lung mass suspicious for ca. reason for this examination: please assess for malignancy, staging. contraindications for iv contrast: none. final report exam: ct torso obtained on . comparison: none. history: 52-year-old male with brain mass, likely a metastasis, assess for malignancy. technique: initial unenhanced transaxial images through the abdomen were obtained. then after iv administration of contrast, transaxial images from the thoracic inlet through the pelvis were obtained. delayed images through the abdomen were obtained. findings: ct thorax: thyroid gland is unremarkable in appearance. the heart is normal in size. there is no pericardial effusion. the thoracic aorta has a normal course and caliber. the pulmonary vasculature is within normal limits. there are diffuse centrilobular emphysematous changes throughout the lungs, with large bullae completely replacing the bilateral apices. within the lingula is a 2.4 x 6.0 cm hypoenhancing mass, which abuts the left lateral ventricle, abutting the pericardium and appears to be invading into the pericardium. the left ventricle, however, does not appear invaded. there are no associated enlarged hilar, mediastinal or axillary lymph nodes. a non- enlarged 5-mm left hilar lymph node is noted. no other lung lesions are identified. mild dependent atelectasis. no pleural effusions. ct abdomen: the liver demonstrates homogeneous post-contrast enhancement without abnormal mass identified. hepatic and portal veins are patent. there is no intrahepatic biliary ductal dilatation. gallbladder, spleen, pancreas, and right adrenal gland are unremarkable in appearance. the left adrenal gland is replaced by 3.1 x 2.6 cm heterogeneously enhancing mass, which resembles the enhancement characteristics of the left lung mass. this most likely represents a metastasis. kidneys demonstrate prompt and symmetric uptake and excretion of contrast. numerous low-attenuating lesions are noted throughout the parenchyma bilaterally, some of which are too small to characterize. however, these statistically likely represent cysts. some of them are definitively cysts. the largest in the right lower pole. the visualized bowel is grossly unremarkable in appearance without bowel wall thickening, inflammatory changes, or obstruction. the abdominal aorta is slightly ectatic in course without aneurysmal dilatation. scattered calcified plaque noted at the infrarenal aorta. multiple borderline, nonenlarged mesenteric lymph nodes are identified. the largest is in the left mid abdomen measuring 1.3 cm in size, with enhancement characteristics similar to the lung mass. no enlarged retroperitoneal lymph nodes are identified. ct pelvis: bowel loops are grossly unremarkable in appearance. bladder is distended with urine. prostate gland calcifications are noted. no free fluid within the pelvis. no enlarged pelvic lymph nodes are identified. there are no osseous destructive lesions. impression: 1. large 6.0 x 2.4 cm hypoenhancing lingular mass, which appears to be invading into the pericardium, likely representing a primary lung carcinoma. there is one non-enlarged left hilar lymph node. additionally, a large left adrenal metastasis is noted measuring 3.1 x 2.6 cm in size. enlarged mesenteric lymph node with central necrosis aslo concerning for metastasis 2. diffuse centrilobular emphysematous changes throughout the lungs with large biapical bulla. ct impression: expected postsurgical appearance status post resection of the left frontal lobe mass. mri impression: 1. 3-cm intra-axial mass at the left frontovertex with small "satellite lesion," anteriorly. there is marked associated vasogenic edema with local mass effect and stable 5 mm rightward shift of the normally-midline structures. 2. the lesion is superficially located and demonstrates more marked rim and central enhancement and is markedly hypercellular, accounting for its uniformly hyperdense appearance on the non-enhanced component of the ct and corresponding restricted diffusion. 3. no evidence of associated hemorrhage. comment: while certain feature, such as the central necrosis and "satellite nodule" are associated with primary glial neoplasms, the hypercellularity and restricted diffusion are quite atypical, with the overall constellation suggestive of either hypercellular metastasis, as seen with small cell bronchogenic carcinoma or, less likely, primary cns lymphoma. mri impression: 1. interval resection of the left frontal mass with a nodular focus of enhancement along the superior margin of the surgical cavity which is concerning for residual tumor. there is similar local mass effect with persistent vasogenic edema. 2. multiple additional nodules throughout the brain suggest that these likely represent metastatic lesions and should be correlated with pathologic findings. 3. findings concerning for pathologically enlarged left level 2 lymph node as detailed above, which is particularly concerning in this clinical context and dedicated imaging of the neck is recommended in further evaluation. there is an ovoid 20 x 12 mm soft tissue density within the left neck (101:64) which is concerning for an enlarged left level 2 lymph node. ct head expected postsurgical appearance status post resection of the left frontal lobe mass. ct neck 1. pathologically enlarged left level iib and iia lymph nodes, with abnormal appearance of rim-enhancement and central relative non-enhancement, similar to recent mr, concerning for metastatic disease, in the appropriate clinical setting. 2. several small cervical nodes, elsewhere. 3. severe biapical bullous emphysema. echo the left atrium and right atrium are normal in cavity size. a patent foramen ovale is present with premature appearance of contrast in the left heart after valsalva release. the estimated right atrial pressure is 0-10mmhg. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). transmitral and tissue doppler imaging suggests normal diastolic function, and a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: patent foramen ovale. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. valvular pathology or pathologic flow identified. brief hospital course: 52y/o m presented to osh with 10 day history of weakness in r arm. he had difficutly writing and grasping objects. he first thought it was d/t the icy-hot that he was using on the shoulder, but when he took the patch off, he realized that the weakness persisted. he then began to notice weakness in his rle with difficulty ambulating. once at the osh, a head ct was performed and showed a 3cm l frontal mass. he was then transferred to for further neurosurgical intervention. once at , he was admitted and started on steroids. he is to have a ct torso to r/o metastasis and mri wand study for or planning. patient was pre-oped for or. on , ct torso revealed a large hypoenhancing lingular mass, which appears to be invading into the pericardium as well as a large l ardenal mass. patient was consented for l parietal craniotomy for resection of mass to be done on . he was brought to the or and underwent the proposed procedure with image guidance. the case was uneventful. he was recovered in the icu and transfered to the floor the following day. the post op ct scan was stable. med onc, neuro onc and rad onc consults were obtained. pt/ot evals were placed and it was determined that patient needs rehab. pt remained neurologically stable and continued to work with physical and occupational therapy. on he was started on a decadron taper. on he was seen by radiation oncology who determined that he would require whole brain radiation therapy. hematology oncology continued to follow the patient and determined that oncology treatment would not be initiated until after completion of his whole brain radiation. all sutures were removed today. on the patient continued to improve neurologically (strengths in upper and lower extremities). on , patient continues to improve. he has been ambulating short distances and strength in rue and proximal rle is 4-/5. he was discharged home with pt. he should have radiation therapy at cancer center and should follow up with thoracic oncology once his radiation therapy is done. medications on admission: none discharge medications: 1. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*28 tablet(s)* refills:*0* 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain/fever. 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 6. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*28 tablet(s)* refills:*0* 7. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*84 tablet(s)* refills:*0* 8. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime). 9. dexamethasone 2 mg tablet sig: one (1) tablet po q8h (every 8 hours). disp:*32 tablet(s)* refills:*0* discharge disposition: extended care facility: crotched mountain discharge diagnosis: l frontal mass discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after sutures and/or staples have been removed. if your wound closure uses dissolvable sutures, you must keep that area dry for 10 days. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? if you have been prescribed dilantin (phenytoin) for anti-seizure medicine, take it as prescribed and follow up with laboratory blood drawing in one week. this can be drawn at your pcp??????s office, but please have the results faxed to . if you haven been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home, unless you have been instructed not to. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: redness, swelling, tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. followup instructions: follow-up appointment instructions ??????please call ( to schedule an appointment with dr. , to be seen in 4 weeks. ??????you will need a ct scan of the brain without contrast. ?????? you have an appointment at cancer center on at 12:30pm for whole brain radiation therapy. it is located at 1 , , . please call with further questions or to make changes. ?????? please call to schedule an appointment with thoracic oncology once your whole brain radiation is complete. ?????? procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other computer assisted surgery diagnoses: tobacco use disorder pulmonary collapse secondary malignant neoplasm of brain and spinal cord ostium secundum type atrial septal defect cerebral edema other emphysema malignant neoplasm of other parts of bronchus or lung 

Answer: The patient is high likely exposed to