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: metastatic cancer major surgical or invasive procedure: ct guided needle biopsy of rul mass history of present illness: the patient is a 62 year old man with history of copd who developed neck spasms in , pcp revealed lung tumor, with inconclusive results biopsy x 2 (via bronch). per pcp c/t-spine ct done, and c-spine ct shows c6 tumor. he reports that approximately two weeks ago he developed r shoulder weakness, tingling, and pain that would radiate to his right hand. at the same time he developed r buttock pain, with intermittent r leg pain. patient was transferred to from hospital for further c-spine work-up and treatment. he was initially admitted to the neurosurgical service for the concern of spinal cord compression. he had mri c/t/l spine that showed diffuse infiltration of the vertebral bodies w/o frank cord compromise. he was transfered to oncology for further management. . currently he denies pain in his arm. he states that he is weak in the shoulder and elbow on the right side. he has no numbness or tingling of his right hand. the left shoulder is also weak but not as much as the right. his legs feel strong to him. . ros: no chest pain. no shortness of breath. no cough. no nausea/vomiting/diarrhea. he feels constipated. no bowel or bladder incontinence. no jaundice. no fever/chills/sweats past medical history: hyperlipidemia social history: non-smoker x 2 years (previously smoked 1.5 ppd x 20 years), rare etoh intake, lives with wife of 14 years. has 2 children from prior marriage. works full time at his dental lab. family history: brother with mi in mid 60s. father died of dementia at 93. mother died of mi at 73. no cancers. physical exam: vitals: 97.3 18 106/62 78 98%ra pain 0/10 gen: thin caucasian male in nad heent: perrl, eomi, anicteric sclera. mmm. neck: no cervical lymphadenopathy. no thyromegaly chest: clear on left. bronchial breath sounds on right upper fields. no dullness. no i:e prolongation cv: rrr no m/r/g abd: flat, soft. nt, active bowel sounds. small but prominent pulsation of abdominal aorta ext: thin. mild digital clubbing. no edema. full rom to both shoulders and elbows. neuro: -ms: alert and oriented x3 coherent response to interview. no extinction -cn: ii-xii intact -motor: normal hand grip. at right deltoid. right bicep. normal finger abduction. hip flex, knee flex/ext, ankle flex/ext -dtr: 2+ biceps, patellars, ankles. toes downgoing bilat. -: light touch intact to face/hands/feet -coord: intact. ftn limited by shoulder strength pertinent results: labs on admission: labs on discharge: imaging: brief hospital course: 62yo m w/ copd admitted with right shoulder pain and weakness found to have large lung mass, with lesions to brain (5 solitary lesions), spine (c5 and t11) and possibly the kidney, unknown primary. 1.lung mass and hypoxia: lung mass presumed to be the primary lesion, given the multiple lesions in ipsilateral and contralateral lung consistent with advanced disease. previous biopsies only obtained necrotic tissue, so unable to identify primary malignancy prior to patients death. throughout the course of his admission he became progressively more hypoxic and tachycardic due to diffuse cancerous involvement of lungs bilaterally as well as associated emphysematous changes. in addition, he likely developed a post obstructive pneumonia. he was intubated on for hypoxic respiratory failure according to the patient and his wife's wishes. he was treated with vancomycin and zosyn for post obstructive pneumonia. given the massive involement of his lungs by tumor it was very unlikely that he would ever come off of ventillatory support. in addition given the late stage and wide spread metastasis of his cancer his prognosis was very poor. this was discussed with the patient and his wife prior to intubation. following his intubation, the decision was made to make him comfort measures only and withdraw ventillatory support on . he died within one hour of withdrawing ventillatory support. he will have a post mortem autopsy according to the family's wishes. 2. metastatic disease: pt has metastatic disease to brain, contralateral lung, and spine (c5 and t11). also possible that he has disease in his kidney, given the abnormal 4.5 x 3.4cm l renal mass seen on ct. also has rising lfts and ruq tenderness, raising concern for liver mets. most likely etiologies are metastatic lung ca vs. metastatic rcc. neurologic status began to progress to involve bilateral arms so he was initially started xrt to c-spine, however this was stopped once his condition progressed to respiratory failure. he was continued on dexamethasone for brain/spinal mets and seizure prophylaxis. 3. leukocytosis: most likely due to combination of steroids and post-obstructive pneumonia. he was treated with vancomycin and zosyn. 4. transaminitis: elevated lfts and ruq pain are concerning for liver metastases. inr 1.4 so may have synthetic dysfunction as well (though pt's nutritional status is also poor which could be contributing). this was not evaluated further due to decline in patient quality of life and change of goals of care to comfort measures only. medications on admission: insulin sc sliding scale lorazepam 0.5 mg iv q8h:prn anxiety acetaminophen 325-650 mg po q6h:prn morphine sulfate 1-3 mg iv q4h:prn pain atorvastatin 10 mg po daily ondansetron 4 mg iv q8h:prn n/v bisacodyl 10 mg po/pr daily oxycodone-acetaminophen tab po q4h:prn pain dexamethasone 4 mg po q6h pantoprazole 40 mg po q24h docusate sodium 100 mg po bid senna 1 tab po bid discharge medications: expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: expired discharge instructions: expired followup instructions: expired procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube arterial catheterization closed [percutaneous] [needle] biopsy of lung diagnoses: pneumonia, organism unspecified acidosis pure hypercholesterolemia malignant neoplasm of liver, secondary unspecified septicemia hyposmolality and/or hyponatremia sepsis acute respiratory failure brachial neuritis or radiculitis nos secondary malignant neoplasm of brain and spinal cord malignant neoplasm of upper lobe, bronchus or lung alkalosis other emphysema encephalopathy, unspecified secondary malignant neoplasm of bone and bone marrow secondary malignant neoplasm of kidney 

Answer: The patient is high likely exposed to