A 55-Year-Old Man States That He Has Noticed an Alteration $40 \mathrm{lb}(18 \mathrm{~kg})$

A 55-year-old man states that he has noticed an alteration in his voice. He has lost $40 \mathrm{lb}(18 \mathrm{~kg})$ and has a persistent cough with blood-stained sputum. He smokes 50 cigarettes a day. On examination, the left vocal fold is immobile and lies in the adducted position. A posteroanterior chest radiograph reveals a large mass in the upper lobe of the left lung with an increase in width of the mediastinal shadow on the left side.
-The symptoms and signs displayed by this patient can be explained by the following statements except which?

A) This patient has advanced carcinoma of the bronchus in the upper lobe of the left lung, which was seen as a mass on the chest radiograph.
B) The carcinoma had metastasized to the bronchomediastinal lymph nodes, causing their enlargement and producing a widening of the mediastinal shadow seen on the chest radiograph.
C) The enlarged lymph nodes had pressed on the left recurrent laryngeal nerve.
D) Partial injury to the recurrent laryngeal nerve resulted in paralysis of the abductor muscles of the vocal cords, leaving the adductor muscles unopposed.
E) The enlarged lymph nodes pressed on the left recurrent nerve as it ascended to the neck anterior to the arch of the aorta.