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: dyspnea major surgical or invasive procedure: thoracentesis with chest tube placement history of present illness: 73 y/o m with hx of rmlobectomy for "benign" mass comes in with approximately one month of worsening sob, doe, orthopnea. also with subjective fatigue, 30 lb unintentional weight loss, and n/v. he does have a productive cough for white sputum, no hemoptysis. has back pain associated with this worsening sob and has been having extensive workups as an outpatient. he was thought to have djd vs. oa as causes of his pain. recent mri of upper back showed suspicious lesion and he was scheduled for biopsy in the next few weeks. due to his worsening sob, his wife insisted that he come to the for evaluation. . in the ed, his vitals were t 97.6, bp 116/72, hr 136, r 18 98% on ra. he was tachypneic and tachycardic throughout ed course. he received 1l ns, dilaudid for pain, and vanco, cefepime and levofloxacin for coverage of hap or cap. thoracic surgery was consulted by the ed team. . upon arrival to the floor, the thoracic surgery team examined him and did a thoracentesis and chest tube placement. the drained about 2 l of serosanginous fluid. he was breathing comfortably and pain free. he was tired and wanted to sleep but otherwise had no other complaints. past medical history: hyperlipidemia oa social history: lives independently with his wife on ; past hx of smoking, quite several years ago (20 pack yr hx), no etoh/drugs family history: father with cancer, unknown primary; otherwise noncontributory physical exam: vitals: t ? bp 120/60, hr 108, 02 sat 96% on ra, rr 16. general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: decreased bs at bases, chest tube in place draining pink serosanginous fluid, few r base crackles, otherwise cta, no respiratory distress cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 02:25pm blood wbc-17.7* rbc-4.88 hgb-15.0 hct-43.2 mcv-89 mch-30.7 mchc-34.7 rdw-13.9 plt ct-487* 04:15am blood wbc-18.2* rbc-4.41* hgb-13.7* hct-39.3* mcv-89 mch-31.1 mchc-34.9 rdw-14.1 plt ct-472* 02:25pm blood pt-14.6* ptt-30.2 inr(pt)-1.3* 04:15am blood pt-13.5* ptt-31.5 inr(pt)-1.2* 02:25pm blood glucose-116* urean-22* creat-0.9 na-140 k-4.8 cl-98 hco3-26 angap-21* 04:15am blood glucose-131* urean-18 creat-0.9 na-140 k-5.0 cl-104 hco3-24 angap-17 02:25pm blood alt-27 ast-44* alkphos-93 totbili-0.9 04:15am blood calcium-8.5 phos-3.9 mg-2.2 uricacd-pnd 04:15pm blood lactate-5.2* 06:22pm blood lactate-5.0* . ct chest/abd/pelvis: chest: the aorta is normal in course and caliber without evidence of dissection or aneurysm. the central pulmonary arterial tree opacifies normally and demonstrates no filling defect to suggest the presence of a pulmonary embolism. there is bulky lymphadenopathy in the anterior, middle and posterior mediastinal compartments with the posterior nodes appearing the largest measuring 2.9 cm in short axis diameter (s400b:33). superior mediastinal nodes measure up to 1.9 cm in short axis diameter (s3:9). conglomerate left hilar lymphadenopathy results in encasement of the bronchovasculature with the large nodes individually approximating 2-cm in short axis diameter (s3:9). nodal encasement of the airway supplying the lingula and left lower lobe resulting in complete atelectasis of these portions of the left lung. additionally, there is nodal encasement of the left lower lobe draining pulmonary vein without evidence of thrombosis at this time, though given this appearance future thrombosis is a likely complication. note is also made of enlarged axillary lymph nodes measuring up to 2.6 cm in short axis on the right and 1.5 cm on the left. an enlarged lymph node is noted just above the left hemidiaphragm on series 3, image 107 measuring 2.4 cm in short axis diameter. there is a large left pleural effusion which layers posteriorly and surrounds the collapsed lingula and left lower lobe. irregular (nodular rind) thickening is noted along the left posterior pleura extending inferiorly from the level of the carina. there is invasion into the left posterio chest wall by this malignant appearing pleural mass. infiltrative mass is seen extending intercostally into the chest wall with a thickness of 4.5 cm (s3:105). in addition, there is a left paraspinal component of this pleural-based mass which may involve and/or extend into the left lower thoracic neural foramina (as described on recent mri). the vertebra and left ribs are intact, though splayed somewhat by the chest wall infiltrative mass. the right lung is essentially clear aside from chronic-appearing consolidation in the right lung apex, which may be related to chronic granulomatous disease. in addition, there is some scarring/suture noted in the right middle lobe which may reflect the provided history of prior partial resection. the heart is normal in size with only trace pericardial thickening versus effusion noted inferiorly. extensive calcification along the tracheobronchial tree is noted. the airway is centrally patent though collapse of the lingula and left lower lobe appears secondary to airway compromise at the level of the left infrahilar region due to the bulky lymphadenopathy. abdomen: the liver appears normal without focal lesion. the portal vein is widely patent. the pancreas, spleen and adrenal glands appear normal. kidneys enhance symmetrically and excrete contrast promptly without evidence of focal concerning renal lesion. lymphadenopathy is noted in the retrocrural space measuring up to 3.2 cm in short axis diameter. additionally, there is enlargement of the celiac axis node measuring up to 2.1 cm. retroperitoneal lymph nodes are also noted, measuring up to 1.9 cm (series 5, image 24). the abdominal aorta and major branch vessels appear patent with minimal calcification along the distal abdominal aorta. the stomach is essentially collapsed. the duodenum follows a normal course. no free air or free fluid is seen. a node is seen inferior to the spleen on series 5, image 36 measuring 11 mm in short axis pelvis: loops of small and large bowel demonstrate no evidence of ileus or obstruction. please note lack of enteric contrast does limit evaluation for bowel wall thickening and mesenteric masses. mesenteric lymph nodes appear grossly unremarkable. there is a small nodule in the right iliac fossa on series 5, image 42. no definite inguinal lymphadenopathy is seen. the urinary bladder is mostly decompressed. the prostate gland is enlarged with a transverse diameter of 5.2 cm. calcified phleboliths are noted in the pelvis. distal ureters opacify normally. no pathologically enlarged lymph nodes are seen along the iliac chain bilaterally. bone windows: while the left paraspinal and left posterior chest wall infiltrative mass is invested between the ribs and appears to enter several left lower thoracic neural foramina (better assessed on mri), there is no bone invasion or evidence of osseous metastasis. spinal alignment appears normal with mild degenerative changes noted in the lower thoracic and lumbar spine. old right posterolateral rib fractures may be related to history of prior partial right lung resection. no acute fractures are seen. diffuse body wall edema is noted. impression: 1. large left posterior pleural mass with invasion into the chest wall with associated large left pleural effusion. abdominal lymphadenopathy as well as bulky mediastinal, left hilar, axillary lymphadenopathy with compression and collapse of the left lower lobe and lingula. overall findings are concerning for malignancy with lymphoma being a strong consideration. correlation with biopsy or cytology (pleural fluid) is recommended. please note, if drainage of the left effusion is attempted, efforts should be made to avoid traversing the pleural soft tissue abnormality. 2. no evidence of pulmonary embolism or acute aortic process. brief hospital course: this is a 73 y/o m with doe, worsening sob and large mediastinal lymphnodes and pleural effusion concerning for malignancy. . # pleural effusion: possibly malignant effusion vs. emphyema. thoracic surgery involved and put in chest tube to drain effusion. fluid consistent with exudate. in clinical setting, does not appear to be infectious. treated with vanco/cefepime/levo in the ed. pathology was equivocal but lymph node biopsy consistent with large b cell lymphoma. chest tube eventually pulled and patient continued to breath well without signs of effusion clinically. . # lymphoma - had l axillary lymph node biopsy confirming diagnosis. was treated initially with dexamethasone and tumor lysis labs were checked often. patient then started . course was complicated by intense fatigue and constipation. was able to move his bowels eventually. patient also was very edematous and receiving lasix daily but was still edematous at the time of discharge. . # dyspnea: pt stable with appropriate rr and o2 sat of high 90s on ra. will continue o2 nc prn, although does not seem to need it. had stable respiratory status throughout admission. . # pain: likely from metastatic disease, will be exacerbated by pain caused after thoracentesis. treated with dilaudid while on 7f and tolerated pain well. . # access - patient had severe swelling in r arm where picc was placed, was pulled the day prior to discharge. did not have a clot based on ue ultrasound. . # hyperlipidemia: stopped statin because of chemo. . # cardiovascular: held aspirin due to fact that counts would drop. . # discharged home wtih close follow up checking labs and following up edema. medications on admission: lipitor 10 mg daily asa 81 mg daily glucosamine supplements variety of narcotics for "sciatica" pain discharge medications: 1. neupogen 480 mcg/0.8 ml syringe sig: one (1) injection once a day. disp:*10 syringes* refills:*0* 2. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. colace 100 mg capsule sig: one (1) capsule po once a day: do not take if having loose stools. disp:*30 capsule(s)* refills:*2* 5. dilaudid 2 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. disp:*15 tablet(s)* refills:*0* discharge disposition: home with service facility: vna assoc. of discharge diagnosis: final diagnosis: 1. large b cell lymphoma 2. malignant pleural effusion discharge condition: patient walking around with walker, afebrile, vital signs normal, still with 2+ pedal edema, 95% on room air discharge instructions: you came to the hospital to have evaluation of a mass seen on a scan done by your pcp. admission you were found to have a large pleural effusion. a chest tube was placed and the fluid was drained. then a biopsy of one of your lymph nodes was done and a diagnosis of large b cell non-hodgkin's lymphoma was made. . for your lymphoma, you were treated with steroids for two days, and then started on chemotherapy called . the chemotherapy lasted 5 days and you tolerated it well except for some severe fatigue. you will need to continue to follow up closely in the clinic for outpatient treatment with methotrexate as well as additional admissions for the treatment. . during your hospital stay, you received a lot of iv fluids and needed lasix to help remove the fluid and decrease your swelling. we are not going to send you home with lasix, and the best way to keep the fluid from collecting in your extremities is to keep them elevated and keep walking around. . you also had a picc line placed in your r arm and had some swelling in your r hand. prior to being discharged, we removed the picc line with hopes that the swelling will start to resolve. . in terms of your medicines, you should start the neupogen shots tomorrow. you should also take allopurionl 300 mg daily. you should take a thiamine vitamin, a colace daily for stool softening and dilaudid pills as needed for pain. these were the pain pills you were getting while in the hospital. only take them if needed. . please call the hospital or be seen in the emergency room for any fevers with a temperature over 100.4, chills, falls, shortness of breath, chest pain, abdominal pain, nausea, vomitting or any other concerns. followup instructions: please follow up in the oncology clinic on saturday, at 1030 am to have your labs rechecked and be seen by a nurse. . then again follow up in the oncology clinic on tues in the morning at 11 am to get treatment. you will then have an appointment after treatment with dr. at 4pm. . please follow up with the interventional pulmonologist dr. on at 1030am. his phone number is ; you can call and try to change the appointment to coincide with an oncology appointment if that would be easier. md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified injection or infusion of cancer chemotherapeutic substance excision of axillary lymph node diagnoses: acidosis candidiasis of mouth other and unspecified hyperlipidemia other malignant lymphomas, unspecified site, extranodal and solid organ sites iatrogenic pneumothorax antineoplastic and immunosuppressive drugs causing adverse effects in therapeutic use other constipation drug induced neutropenia neoplasm related pain (acute) (chronic) other lymphedema shortness of breath personal history of surgery to other organs malignant pleural effusion 

Answer: The patient is high likely exposed to