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: gemcitabine attending: addendum: gemcitabine has been added as an allergy given the possibility that the patient's atypical pneumonia is due to gemcitabine pulmonary toxicity. . the patient also noted new right forearm pain 2 days prior to discharge for which plain films were obtained and read as negative for metastatic disease. . the final read of her t and l spine mri obtained on her day of discharge is also included below. pertinent results: plain films of right forearm: right forearm, two views: two views of the right forearm show no evidence of fracture. there is no suspicious lytic lesion or focal osseous destruction. calcification adjacent to the medial epicondyle may represent calcific tendinitis. if there remains concern for metastasis, bone scan or mri may be considered for further evaluation. . t and l spine mri final results: thoracic spine: alignment remains anatomic. there is diffuse underlying low marrow signal within the thoracic spine, increased compared to . this may represent diffuse marrow infiltration with metastases or post-treatment changes. more focal regions of osseous metastatic disease in the thoracic vertebrae, most prominent in t2, t3, t6, t7, t8, t9 and t12 are slightly increased compared to prior. there is no evidence of interval fracture. underlying degenerative changes include a schmorl's nodes at the superior endplate of t7 and a disc herniation at t11-t12 which indents the anterior thecal sac. the spinal cord has normal contour and signal. there is no suspicious epidural enhancement and no suspicious intradural or intramedullary enhancement. . the partially visualized lungs are significant for moderate left and small right pleural effusions and heterogeneous signal within the lungs which is better evaluated on the ct. . lumbar spine: alignment remains anatomic. compared to , there has been interval progression of the osseous metastases within the lumbar spine and sacrum with progression of abnormal enhancing low t1, high t2 signal lesions. there has been interval progression of the irregularity of the superior endplate of l3 likely due to metastatic involvement. otherwise, the cortices appear intact. the conus medullaris terminates at the level of l1 with normal contour and signal. there is no abnormal enhancement within the thecal sac and no evidence of epidural or intramedullary metastases. underlying degenerative changes include moderate bilateral facet arthropathy at l4-l5. the synovial cyst adjacent to the left l4-l5 facet is no longer evident. . impression: 1. no spinal canal narrowing, no evidence of metastases within the thecal sac. 2. slight interval progression of osseous metastatic disease with new irregularity of the superior endplate of l3. discharge disposition: home with service facility: md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours venous catheterization, not elsewhere classified insertion of endotracheal tube arterial catheterization closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified obstructive sleep apnea (adult)(pediatric) anemia, unspecified esophageal reflux unspecified pleural effusion acute kidney failure, unspecified personal history of malignant neoplasm of breast hypopotassemia dysthymic disorder other and unspecified hyperlipidemia acute respiratory failure secondary malignant neoplasm of lung secondary malignant neoplasm of bone and bone marrow urinary incontinence, unspecified insomnia, unspecified other drugs and medicinal substances causing adverse effects in therapeutic use nephritis and nephropathy, not specified as acute or chronic, with unspecified pathological lesion in kidney 

Answer: The patient is high likely exposed to