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. Cachexia is common, and patients frequently die of sepsis. Lymphocytopenia may occur early and become pronounced with advanced disease. Anemia, often microcytic, usually develops with advanced disease. In advanced anemia, defective iron reutilization is characterized by low serum iron, low iron-binding capacity, and increased bone marrow iron.