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: history of present illness: this is a 74-year-old woman with history of alzheimer's disease and hypercholesterolemia who has had two to three months of 25 pound weight loss, anorexia and dysphagia. she also reports increased burping. this was thought initially to be a side effect of aricept, which was started approximately six months ago, however, with persistence of these symptoms, she reported to her primary care physician's who initiated a malignancy work-up. she was found to have pulmonary nodules on chest x-ray suspicious for lung metastases, guaiac positive stools, anemia, increased lfts and also a bone scan positive for metastatic disease. the primary site of cancer was unknown. she was scheduled for a barium swallow on and it is unclear whether this was done or not. she had a negative mammogram in . she was scheduled for a colonoscopy and esophagogastroduodenoscopy as an outpatient on the morning of admission, however, earlier that morning, she had an episode of bright red blood, hematemesis/hemoptysis after taking her pills. it was only approximately one ounce in quantity. there were no clots and no sputum. she had no other associated symptoms of nausea, vomiting, chest pain, lightheadedness, melena, bright red blood per rectum or abdominal pain. her husband also reports she had transient hematuria ten years ago. an intravenous pyelogram was done with tomography with finding of widened bladder neck, otherwise, normal. the patient was sent from the emergency room where her vital signs were stable to the esophagogastroduodenoscopy suite where it was revealed an abnormal mucosa in the esophagus from 30 cm to 22 cm distally with adherent clot and moderate oozing. colonoscopy was not performed at that time secondary to active bleeding and she was transferred to the medical intensive care unit for one night for observation. past medical history: 1. alzheimer's disease. 2. weight loss, dysphagia, anorexia, pulmonary nodules on chest x-ray guaiac positive stools, metastatic bone lesion on bone scan, increased lfts, 3. hypercholesterolemia. medications at home: aricept 5 mg po q.d., lipitor 10 mg po q.d., prempro .625/2.5 mg q.d., centrum multivitamin. family history: no coronary artery disease. father with duodenal/stomach cancer. mother with question of mass in chest. allergies: no known drug allergies. social history: lives with her husband. one son, two grandchildren. she smokes less than one pack per day times 35 years and has occasional alcohol use. review of systems: no fevers, chills, nausea, vomiting, shortness of breath or chest pain. physical examination: vital signs: temperature 99.1. pulse 96. blood pressure 113/54. respiratory rate 14-18. o2 saturation 100% on two liters nasal cannula. in general in no acute distress, pleasant woman. neck: no lymphadenopathy, no thyromegaly, no axillary lymphadenopathy. head, eyes, ears, nose and throat: anicteric sclerae, dry mucous membranes. cardiovascular: regular rate and rhythm, no murmurs, rubs or gallops. pulmonary: clear to auscultation bilaterally. abdomen: soft, nontender, question of palpable liver edge 2 cm below diaphragm. extremities: no edema. neurological: cranial nerves intact. left lower extremity greater than right lower extremity weakness, on the left and on the right. laboratory data on admission: white blood cell count 12.5, hematocrit 26.8, platelets 361,000. neutrophils 87%, lymphocytes 8%, monocytes 5%, inr 1.1, pt 12.7, ptt 24.9. sodium 138, potassium 3.3, chloride 99, bicarbonate 26, bun 23, creatinine .8, glucose 120. work-up prior to admission on : sedimentation rate 68, alt 33, ast 71, alkaline phosphatase 296, t bilirubin .8, ggt 81, albumin 3.8, total protein 6.9, globulin 3.1, calcium 9.9, tsh 2.6, iron 3, total cholesterol 218, tibc 280, b12 984, folate greater than 20, ferritin 245, trf 215, hdl 65, cholesterol to hdl ratio 3.4, spep abnormal band in gamma region 2% of total protein, igg 698, iga 318, igm 214, ife monoclonal igm cap was seen. 24 hour urine: ph 5, protein 15, volume 380 cc, upep no bence proteins, only albumin. urine culture on negative. ct of the head without contrast : moderate atrophy without significant abnormalities. mammogram : no evidence of malignancy. chest pa and lateral : extensive pulmonary and right hilar metastases. left hip x-ray : normal pelvis and left hip. bone scan : positive for multiple foci of increased activity, most likely secondary to metastatic disease, particularly in the right iliac crest within parietal region of calvaria. esophagogastroduodenoscopy : normal stomach, normal duodenum, esophagus with abnormal mucosa with bleeding in esophagus from 30 cm where the te junction is seen to 22 cm proximally, adherent clot, active bleeding and friability. lumen narrowed with ulceration and irregular mucosa. no varices. biopsy performed at lower of esophagus and middle of esophagus. impression: this is a 74-year-old woman with metastatic cancer of unclear etiology, although esophagogastroduodenoscopy results reveal bleeding ulcerations along the esophagus suggesting primary adenocarcinoma of the esophagus. summary of hospital course: 1. bleeding eosphageal ulcerations: likely eosphageal cancer. patient was in the medical intensive care unit for one night and supported with intravenous fluids and transfused two units. she remained hemodynamically stable and hematocrit also bumped up appropriately to above 30 with the transfusions and remained stable throughout her hospital stay. two large bore ivs were placed. patient had no more episodes of hematemesis or any other signs of active bleeding. she was transferred to the floor after one night in the medical intensive care unit and her diet was advanced with good toleration. patient was placed on a protonix drip in the unit and once she came to the floor was on protonix 40 mg po b.i.d. on the second day of admission, she was noted to have increased coagulation factors. inr 1.5, pt 14.6, ptt 25.7. she was started on vitamin k subcutaneous injections times three days and her coagulation laboratories normalized by the time of discharge. 2. hematology/oncology: patient was seen in the hospital by dr. from hematology/oncology who had already seen her once as an outpatient. the biopsy taken during esophagogastroduodenoscopy was nondiagnostic as it was mainly clot and necrotic tissue. however, a ct scan was done of her torso showing mediastinal lymphadenopathy, right hilar adenopathy, dilation of esophagus with air fluid level in the distal esophagus and distal esophageal wall markedly thickened beyond te junction suspicious for malignancy. innumerable pulmonary metastatic lesions and metastatic liver lesions, little normal liver tissue left, right adrenal mass likely metastases, renal cyst bilaterally, no free fluid or free air in the peritoneal cavity or pelvic cavity, no lytic or blast lesions seen in the bone. of note, cavitary metastatic lesions in lungs suggestive of squamous cell primary. given this, result of her ct scan, as well as what was done prior with definite metastatic disease, the patient's husband was seen by the home hospice service and choose this as the next route management. dr. and her oncologist also felt that were no aggressive therapeutic measures to be done at this point, however, at a later time, if she becomes more symptomatic in terms of her swallowing or breathing, there may be room for palliative radiation or stenting placement in her esophagus. the patient will follow-up with dr. as an outpatient. she was discharged to home hospice. 3. alzheimer's disease. appears to be moderate. patient's family very supportive, making decisions for her. aricept was held given her esophageal ulcerations. condition of discharge: stable. discharge status: home with home hospice. discharge medications: 1. protonix 40 mg po b.i.d. 2. other medications the same except for her aricept, which was discontinued. discharge diagnoses: 1. alzheimer's disease. 2. hypercholesterolemia. 3. metastatic cancer, possibly of eosphageal origin. , m.d. dictated by: medquist36 procedure: esophagogastroduodenoscopy [egd] with closed biopsy diagnoses: pure hypercholesterolemia malignant neoplasm of liver, secondary secondary malignant neoplasm of lung alzheimer's disease malignant neoplasm of lower third of esophagus secondary malignant neoplasm of bone and bone marrow esophageal hemorrhage anemia in neoplastic disease secondary malignant neoplasm of adrenal gland 

Answer: The patient is high likely exposed to