Which of the following is NOT a sign of carcinoma?

Fluid in the lungs is not typically considered a direct sign of carcinoma. Carcinoma refers specifically to cancer that arises from epithelial cells, which can occur in various organs, including the lungs, throat, and neck. While hoarseness, a lump in the neck, and dysphagia can be directly associated with the presence of tumors or malignancies affecting the throat or larynx, fluid in the lungs—known as pulmonary edema—can be caused by a variety of conditions such as heart failure, pneumonia, or other non-cancerous factors. Therefore, it does not directly indicate the presence of carcinoma, making it the correct choice in this context.