Other manifestations develop as the disease spreads through the reticuloendothelial system, generally among contiguous sites. Although the mechanism is unclear, immediate pain may occur in diseased areas after drinking alcoholic beverages, providing an early clue to diagnosis. Pancytopenia is occasionally caused by bone marrow invasion, usually by the lymphocyte-depleted type. Epidural invasion that compresses the spinal cord may result in paraplegia. Horner's syndrome and laryngeal paralysis may result when enlarged lymph nodes compress the cervical sympathetic and recurrent laryngeal nerves, respectively.
Neuralgic pain follows nerve root compression.
Intracranial, gastric, and cutaneous lesions occur rarely and, if present, suggest HIV-associated Hodgkin's disease. Intrahepatic or extrahepatic bile duct obstruction by tumor masses produces jaundice. Leg edema may follow lymphatic obstruction in the pelvis or groin. Tracheobronchial compression can cause severe dyspnea and wheezing. Infiltration of lung parenchyma may simulate lobar consolidation or bronchopneumonia and may result in cavitation or lung abscess.