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: no known allergies / adverse drug reactions attending: chief complaint: headache and right facial droop. major surgical or invasive procedure: ct guided stereotaxic biopsy. history of present illness: this is a 61-yearold right-handed woman with history of migraines, glaucoma who presented from at for further evaluation of abnormal finding brain mri findings. patient was seeing dr for several months for chronic right hip pain and acute on chronic headache, when she noticed that she had a facial droop. the timeline of the onset of this new finding remains unclear, she states that she has always had an asymmetrical face. a brain mri was ordered and found to be abnormal with lesion noted in the left thalamus. she reports a history of migraines for the past 20 years. however, she reports headaches which have become progressively worse over the past 1 month and these headaches have now tended to wake her up from bed. she also reports subtle speech changes which was first been noticed by her sister. she further reports ataxia she denies any seizures, fever, chills, niight sweat or weight lost. on general review of systems, the pt denies recent fever or chills. denies cough, shortness of breath. she denies chest pain or tightness, palpitations. she denies nausea, vomiting, diarrhea, constipation or abdominal pain. she has no recent change in bowel or bladder habits. she has no dysuria. she denies arthralgias, myalgias, or rash. neurological review of systems: she denies other than those mentioned in the hpi. past medical history: -diverticulosis -migraine headaches: left frontal, occasionally migraine to the back of the left head, with photophobia, nausea, ultimately severe. she sees a dr. at the for this, at his headache treatment center, and has had considerable improvement after starting verapamil as a prophylactic . she tried other agents such as amitriptyline 10 mg which made her very groggy, and topamax which gave her insomnia and other side effects. -mgus -glaucoma -chronic dry eyes -constipation -benign ovarian tumor status post resection -breast lumps -l4/l5 radiculopathy social history: she is a part-time teacher of english as a foreign language at the shoa institute in . she holds a master's degree. she lives with his sister. she does not smoke. she uses alcohol rarely. family history: it is notable for idiopathic pulmonary fibrosis, colorectal cancer, and hiv in her father, and granulomatosis in a sister. there is also b-cell lymphoma in her family. she does not have children. physical exam: vital signs: temperature 97.2 f, blood pressure 110/60, pulse 62, respiration 18, and karofsky performance score 80. general: awake, cooperative, nad. skin: no rashes or lesions noted. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx. neck: supple, no masses or lymphadenopathy. pulmonary: lungs cta bilaterally without r/r/w. cardiovascular: rrr, nl. s1s2, no m/r/g noted. abdomen: soft, nt/nd, no masses or organomegaly noted. extremities: warm and well perfused. neurological examination: -mental status: alert, oriented x 3. able to relate history without difficulty. attentive, able to name backward without difficulty. language is fluent with intact repetition and comprehension. normal prosody. there were no paraphasic errors. patient was able to name both high and low frequency objects. she is able to read without difficulty. speech was slightly dysarthric. she is able to follow both midline and appendicular commands. she is able to register 3 objects and recall at 5 minutes. she has good knowledge of current events. there was no evidence of apraxia or neglect. -cranial nerves: i: olfaction not tested. ii: perrl 3 to 2mm and brisk. vff to confrontation. iii, iv and vi: eom are intact and full, no nystagmus. v: facial sensation intact to light touch. vii: right nasal labial flattening, facial musculature symmetric during smile. viii: hearing intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. pronator drift on right. no adventitious movements, such as tremor, noted. no asterixis noted. delt bic tri wre ffl fe io ip quad ham ta edb l 5 5 5 5 5 5 5 5 5 5 5 5 5 5 r 5- 4+ 4+ 5 5 5 5 5 5 5 5 5 5 5 -sensory: no deficits to light touch, pinprick, cold sensation, proprioception throughout. no extinction to dss. -dtrs: tri pat ach l 2 2 2 3 1 r 2 2 2 2 1 plantar response: mute bilaterally -coordination: no intention tremor, no dysdiadochokinesia noted. no dysmetria on fnf or hks bilaterally. -gait: defered. pertinent results: admission labs: 07:50pm blood wbc-3.1* rbc-4.54 hgb-13.8 hct-39.8 mcv-88 mch-30.4 mchc-34.7 rdw-13.5 plt ct-221 07:50pm blood neuts-52.2 lymphs-38.7 monos-6.8 eos-1.9 baso-0.4 07:50pm blood pt-11.7 ptt-28.5 inr(pt)-1.1 07:50pm blood cd5-done cd16-done cd23-done cd56-done cd45-done hla-dr 7-done kappa-done cd2-done cd7-done cd10-done cd19-done cd20-done lambda-done cd57-done 07:50pm blood cd3%-done cd4%-done cd8%-done 07:50pm blood ipt-done 07:50pm blood glucose-130* urean-14 creat-0.6 na-136 k-3.9 cl-101 hco3-28 angap-11 07:50pm blood alt-38 ast-49* ld(ldh)-281* alkphos-98 totbili-0.3 07:50pm blood totprot-7.1 albumin-4.2 globuln-2.9 calcium-9.5 phos-3.6 mg-2.0 07:50pm blood pep-abnormal b b2micro-3.0* ife-monoclonal 07:50pm blood hiv ab-negative 07:50pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg imaging: ct chest, abdomen, and pelvis findings: chest: no evidence for axillary, hilar, or mediastinal lymphadenopathy. no pleural effusions. a 2-mm nodule is identified in the superior aspect of the right lower lobe and a 4-mm nodule is identified in the superior aspect of the left lower lobe. followup imaging is recommended. a 10-mm bleb is identified in the left lower lobe as also a 2.3-cm bleb in the medial aspect of the right lower lobe. abdomen: the liver and spleen are normal in size. no focal hepatic lesions are identified. the gallbladder, pancreas, adrenals, and kidneys are unremarkable. there is no evidence for hydronephrosis or nephrolithiasis. there is no retroperitoneal or mesenteric lymphadenopathy. pelvis: the small and large bowel is unremarkable. the patient is status post hysterectomy and bilateral salpingo-oophorectomy. the urinary bladder is well distended and does not show any gross abnormalities. review of images on bone windows does not show any suspicious bony lesions. impression: 1. no systemic processes such as lymphoma are identified. no evidence for lymphadenopathy. 2. a 2-mm pulmonary nodule is identified in the right lower lobe and a 4-mm pulmonary nodule is identified in the left lower lobe. followup imaging is recommended. mri cervical, thoracic, and lumbar spine findings: there is normal lordotic curvature of the cervical and lumbar as well as kyphotic curvature of the thoracic spine. there is mild anterolisthesis of c4 on c5 (less than grade 1). otherwise, the dorsal alignment as well as vertebral body height are well maintained. the vertebral body bone marrow signal is likewise unremarkable. discrete disc bulges at the level of the cervical spine are identified at c4/c5, c5/c6, and c6/c7, mildly indenting the anterior thecal sac, but without evidence of spinal canal stenosis. no significant degenerative changes are seen involving the thoracic spine. at l3/l4, there is diffuse disc bulge with superimposed right foraminal protrusion. the spinal canal is patent, the right neural foramen is mildly narrowed by facet joint osteophytes and disc material. at l4/l5, there is diffuse disc bulge without spinal canal stenosis. the bilateral neural foramina are narrowed by facet joint arthropathy, mild on the left and moderate on the right. at l5/s1, there is loss of disc height with diffuse bulge, but no spinal canal stenosis. the bilateral neural foramina are narrowed due to facet joint arthropathy and posterior endplate osteophytes, moderate on the right and mild on the left. the craniocervical junction is normal. the cervical and thoracic cord, conus and cauda equina demonstrate normal morphology and intrinsic t2 signal. there is no abnormal enhancement involving cord, conus, cauda, or meninges. the posterior elements and paraspinal soft tissues are unremarkable. impression: 1. no evidence of medullary involvement or leptomeningeal spread. 2. mild degenerative changes involving the cervical and lumbar spine as detailed above. ct head: findings: a ct stereotaxis devise surrounds the visualized aspect of the brain. centered within the left thalamus there is a 14 x 9 mm hyperattenuating focal lesion, presumed to be related to the lesion of interest. in addition a second more linear focus of hyperattenuation is demonstrated within the left temporal subinsular region (2:22) measuring up to 11 mm. there is surrounding hypoattenuation compatible with adjacent edema. there is associated mass effect with mild rightward shift of normally midline structures by approximately 6 mm. evaluation of the posterior far fossa is extremely limited by artifact. there is no evidence of acute infarction with preservation of the -white matter differentiation. the ventricles and sulci are normal in size and configuration. there is no acute fracture. the visualized portions of the paranasal sinuses and mastoid air cells are well aerated. impression: ct stereotaxis of known hyperattenuating lesion measuring up to 1.4 cm centered within the left thalamus with associated surrounding vasogenic edema and mass effect with shift of normally midline structures to the right by 6 mm. echocardiogram: the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. no clinically-significant valvular disease seen. ct head w/o contrast: findings: a small amount of air and hemorrhage along the biopsy tract is stable. vasogenic edema surrounding the left thalamic lesion, exerts stable rightward shift of normally midline structures measuring approximately 7 mm. no new hemorrhage, major vascular territorial infarction, edema, mass or hydrocephalus is noted. left frontal pneumocephalus is unchanged. a left frontal burr hole is again seen. size of the ventricles and sulci is unchanged. the basal cisterns are patent. visualized paranasal sinuses and mastoid air cells are well aerated. impression: stable post-biopsy changes after biopsy of a left thalamic lesion. biopsy tract blood products and associated vasogenic edema are stable. csf 01:27pm cerebrospinal fluid (csf) wbc-4 rbc-1* polys-0 lymphs-80 monos-20 01:27pm cerebrospinal fluid (csf) totprot-78* glucose-60 ld(ldh)-25 01:27pm cerebrospinal fluid (csf) csf-pep-no oligocl methotrexate levels: 05:13am blood mthotrx-0.02 05:49pm blood mthotrx-0.05 05:49am blood mthotrx-0.07 discharge labs: 05:13am blood wbc-5.2 rbc-3.89* hgb-11.8* hct-34.4* mcv-88 mch-30.4 mchc-34.4 rdw-13.5 plt ct-209 05:13am blood glucose-107* urean-10 creat-0.4 na-136 k-3.4 cl-99 hco3-29 angap-11 05:13am blood alt-230* ast-241* ld(ldh)-375* alkphos-78 totbili-0.3 05:13am blood calcium-8.8 phos-3.7 mg-1.8 brief hospital course: ms. is a 61-year-old woman with a history of diverticulosis, migraine headaches, glaucoma, l4/l5 radiculopathy on gabapentin presenting with worsening headaches and a right facial droop, found to have a left thalamic contrast enhancing mass on mri. (1) likely cns lymphoma: examination on admission was notable for a mild right facial droop, and mild right arm weakness in an umn pattern. on admission she underwent a lumbar puncture for cytology, results still pending. on she underwent a stereotactic guided biopsy of the thalamic lesion, with preliminary pathology consistent with lymphoma, for which she was transferred to the floor for treatment with high dose methotrexate. patient on arrival to floor had infusion on , with alkalkination of urine to ph >8 which was consistently monitored. her methotrexate levels were drawn and found to be very low .02 prior to discharge. she also underwent a leucovorin rescue s/p infusion of methotrexate. patient's pathology from her biopsy was concerning for cns lymphoma. she was given dexamethasone for help with intracranial swelling post biopsy, and also due to her nausea/headache symptoms. she will continue the dexamehtasone as an outpatient. (2) headache: likely combination of post-op pain and migraine. her home verapmil was changed to short acting while inpatient, and she was given dexamethasone and fioricet prn with good improvement in her headache. her home maxalt was stopped. (3) nausea: patient was given reglan, and zofran for help with nausea emesis. this was relieved prior to discharge without any episodes of emesis. (4) cataracts: continued on home eye gtts (5) rosacea: contnued home doxycycline (6) code status: full code transitional issues: (1) patient will be admitted on friday for port-a-cath placement with plan for another cycle of induction high-dose methotrexate. medications on admission: restasis eye drops timolol eye 1 drop both eyes omega-3 fatty acids flax seed doxycycline 100bid maxalt 10mg prn migraine aleve prn migraine fioricet prn migraine gabapentin 300mg daily fluticasone spray verapamil 480mg daily discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for headache, fever t>38.3c. 2. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 3. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal daily (daily). 4. timolol maleate 0.5 % drops sig: one (1) drop ophthalmic daily (daily). 5. cyclosporine 0.05 % dropperette sig: one (1) drop ophthalmic (2 times a day). 6. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 8. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 9. verapamil 240 mg tablet extended release sig: two (2) tablet extended release po once a day. 10. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for headache. 11. dexamethasone 4 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 12. docusate sodium 100 mg capsule sig: two (2) capsule po twice a day. 13. omega-3 fatty acids-fish oil 300-1,000 mg capsule sig: one (1) capsule po once a day. capsule(s) discharge disposition: home discharge diagnosis: primary diagnosis: cns lymphoma secondary diagnosis: -migraine headaches -monclonal gammopathy of undertermined significance -glaucoma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. discharge instructions: dear ms. , you were admitted to after having some neurological issues with facial droop and headaches. you were seen by the neurosurgery team who performed a biopsy in your brain. aftewards, you received a ct scan of your head due to concern for swelling/bleeding in the brain which was negative. the prelimnary biopsy results were consistent with a lymphoma, and therfore you were given a dose of chemotherapy treatment (methotrexate). you were monitored during the infusion of your chemotherapy, and will require more therapy. please see your scheduling below as you will need to have a port placed in order to receive your chemo infusions in the future. you will be discharged on a steroid medication in order to help you with your headaches, please take this as prescribed. medication changes: start dexamethasone as prescribed stop maxalt 10mg general 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 have been removed. ?????? 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. ?????? you were not on a medication such as coumadin (warfarin), or plavix (clopidogrel), or aspirin, prior to your surgery, if a physician these medications to you please call our office prior to initiation. ?????? 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 ?????? you are scheduled to have a port-a-cath placed on friday . you should check in at 11 around 10:00 am for placement. you will be admitted following the procedure and are scheduled for chemotherapy 3 days later. you will have your sutures removed by surgery at that time. ?????? 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. procedure: spinal tap incision of lung closed [percutaneous] [needle] biopsy of brain injection or infusion of cancer chemotherapeutic substance other immobilization, pressure, and attention to wound central venous catheter placement with guidance diagnoses: unspecified glaucoma cerebral edema nausea alone migraine, unspecified, without mention of intractable migraine without mention of status migrainosus acquired absence of both cervix and uterus family history of malignant neoplasm of breast other cataract rosacea other acute postoperative pain glaucoma stage, unspecified family history of other lymphatic and hematopoietic neoplasms primary central nervous system lymphoma, unspecified site, extranodal and solid organ sites 

Answer: The patient is high likely exposed to