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: back pain major surgical or invasive procedure: t9-l2 fusion with vertebrectomies t10/l2 history of present illness: 47-year-old gentleman who unfortunately has been diagnosed with a lung carcinoma. he suffered metastasis to the t10-l1 vertebral bodies. he is relatively asymptomatic but on serial fdg pet scan, the metastasis is still metabolically active. the volume of the lesion is significant and does suggest potential instability. he denies any difficulty with bowel, bladder, or gait. he has no positional symptoms at present. he has undergone ck to the area and now presents for spinal stabilization. past medical history: 1. ncslc, stage iv, as described above, diagnosed in , complicated by diffuse metastatic disease to left adrenal, right mandible, sternum, left sacrum, left femoral head, right lesser trochanger, destructive lesions of the t10 and l1 vertebra with possible spinal canal extension, now on cyberknife treatment for vertebral lesions, after poor response to carboplatin and pemetrexed, now awaiting treatment with erlotinib. 2. hodgkin's disease, stage iia, diagnosed in , treated with radiation, then with relapse in , treated with chemotherapy. 3. s/p splenectomy social history: the patient is married and has three children, . he works previously worked in software, now not working. he enjoys playing the violin. he has never smoked. he drinks alcohol occasionally. family history: from omr: the patient's mother is 75 years old and has diabetes and obesity. his father is 76 years old and is well. the patient's maternal grandmother is 101. of his grandparents have malignancies. the patient's mother has one brother, and the patient's father had two brothers and two sisters, none of whom have a history of cancer. the patient has one brother, age 49, who is well. physical exam: on examination, his motor strength is in hip flexion,extension, quadriceps, hamstrings, dorsiflexion, and plantar flexion bilaterally. his sensory examination was intact with respect to the modality of light touch. his reflexes were normal and symmetric. the straight leg raise was negative bilaterally as was the maneuver. his back was flat and nontender. pertinent results: pathology reports are still pending at the time of this summary radiology report chest (portable ap) study date of 5:59 pm 7:38 pm final report single ap portable view of the chest reason for exam: status post posterior fusion t10-l1. comparison is made with prior study dating back . cardiac size is normal. et tube is in standard position 4.8 cm above the carina. right ij catheter tip is in the upper right atrium. multifocal opacities in the right lung greater on the upper lobe have improved. unchanged fullness of the right hilum and right paratracheal stripe due to patient's known lymphadenopathy. hardware is seen in the thoracolumbar region there is no pneumothorax or large pleural effusion. the study and the report were reviewed by the staff radiologist. radiology report t-spine study date of 11:45 am final report thoracic spine, clinical information: fusion t9-l2. standing radiographs obtained demonstrating fusion hardware from t9 through l2 with pedicle screws, posterior fusion rods and interbody fusion devices. an ivc filter and multiple surgical clips are present. alignment is maintained. there is some loss of disc height at several levels. surgical drain is present. staples are present along the midline posteriorly. there is mildly dilated small bowel, likely secondary to ileus. continued observation recommended. complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 05:54 12.6* 2.96* 8.8* 26.5* 89 29.8 33.3 18.6* 223 source: line-right ij basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 05:54 223 source: line-right ij basic coagulation (fibrinogen, dd, tt, reptilase, bt) fibrino 07:30 448* lab use only 05:54 source: line-right ij chemistry renal & glucose glucose urean creat na k cl hco3 angap 05:54 122*1 5* 0.6 137 3.5 107 22 12 source: line-right ij if fasting, 70-100 normal, >125 provisional diabetes estimated gfr (mdrd calculation) estgfr 17:18 using this1 source: line-aline using this patient's age, gender, and serum creatinine value of 0.4, estimated gfr = >75 if non african-american (ml/min/1.73 m2) estimated gfr = >75 if african-american (ml/min/1.73 m2) for comparison, mean gfr for age group 40-49 is 99 (ml/min/1.73 m2) gfr<60 = chronic kidney disease, gfr<15 = kidney failure enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili 19:30 19 30 170 69 102* 0.6 source: line-arterial other enzymes & bilirubins lipase 19:30 19 source: line-arterial chemistry totprot albumin globuln calcium phos mg uricacd iron 05:54 9.0 2.3* 1.8 source: line-right ij brief hospital course: pt was admitted electively and brought to or where under general anesthesia he underwent posterior fusion. he tolerated this well, was brought to pacu intubated and was safely extubated 3 hours post-op.post op exam should full motor strength. postop his pain was managed and titrated to po meds. his diet and activity were advanced. he had jp drain placed intraop which was monitored and removed . foley was removed . he continued to do well and his hct remained stable. he was cleared for d/c to home by pt. it was noted that he had tachycardia for most of his hospital course. he stated this was the norm for him and he remains asymptomatic. he agree's with the plan for d/c to home. medications on admission: ambien 5 mg po qhs prn tessalon perles prn oxycodone 5 mg po prn discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain: be sure not to take more than 4000mg of tylenol per day . 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 3. multivitamin tablet sig: one (1) tablet po daily (daily). 4. enoxaparin 30 mg/0.3 ml syringe sig: one (1) as previously prescribed subcutaneous q12h (every 12 hours): please contact dr if your weight has changed - this may change the dose of this medication . 5. benzonatate 100 mg capsule sig: one (1) capsule po bid (2 times a day). 6. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 7. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 8. oxycodone 5 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*60 tablet(s)* refills:*0* 9. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for no bm >24hr. 10. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 11. methocarbamol 500 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*135 tablet(s)* refills:*0* 12. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. tarceva 150 mg tablet sig: one (1) tablet po once a day: you may now restart this medication. discharge disposition: home discharge diagnosis: metastatic lesions to spine with instability discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: discharge instructions for spine cases ?????? do not smoke ?????? keep wound clean / no tub baths or pools until seen in follow up/ begin daily showers ?????? no pulling up, lifting> 10 lbs., excessive bending or twisting for two weeks. ?????? limit your use of stairs to 2-3 times per day ?????? have a family member check your incision daily for signs of infection ?????? take pain medication as instructed; you may find it best if taken in the a.m. when you wake if you experience muscle stiffness and before bed for sleeping discomfort ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, ibuprofen etc. for 3 months. * you may resume yout tarceva upon discharge. ?????? increase your intake of fluids and fiber as pain medicine (narcotics) can cause constipation followup instructions: please return to the office in days from the date of your surgery for removal of your staples please call to schedule an appointment with dr. to be seen in 6 weeks. you will need xrays prior to your appointment procedure: dorsal and dorsolumbar fusion of the anterior column, anterior technique other excision of joint, other specified sites dorsal and dorsolumbar fusion of the posterior column, posterior technique insertion of interbody spinal fusion device fusion or refusion of 4-8 vertebrae diagnoses: malignant neoplasm of kidney, except pelvis secondary malignant neoplasm of bone and bone marrow personal history of hodgkin's disease secondary malignant neoplasm of adrenal gland 

Answer: The patient is high likely exposed to