Does Mono Cause Lymphoma?

Mononucleosis Has Been Mistaken for Lymphoma

In medicine, viruses and cancers can be linked, sometimes more readily than one might expect. But it’s important to remember that very few viruses are known to be necessary and sufficient to cause cancer on their own. Connection is not always cause, but there are some notable exceptions.

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Does Mononucleosis Cause Lymphoma?

Most people recognize infectious mononucleosis, or mono, as the kissing disease that a teen, adolescent or college student might contract. Epstein-Barr virus (EBV) is the virus responsible for mononucleosis. EBV can also (in addition to kissing) be transmitted through coughing, sneezing, or by sharing drinking or eating utensils. Most people in the United States are infected with EBV by the end of their teen years, although not everyone develops the symptoms of mono.

EBV is a risk factor for certain kinds of lymphoma, but it would be incorrect to say that EBV is the cause of lymphoma. According to the American Cancer Society, EBV infection doesn’t cause serious problems in most people:

  • EBV infection increases risk of nasopharyngeal cancer and certain types of fast-growing lymphomas such as Burkitt lymphoma
  • EBV may also be linked to Hodgkin lymphoma and some stomach cancers
  • EBV-related cancers are more common in Africa and parts of Southeast Asia; and overall, very few people who have been infected with EBV will ever develop these cancers.

When EBV does lead to cancer, it’s believed other risk factors are also involved. For more on this and the interplay between diseases, learn about the connection between EBV and lymphoma by Dr. Mallick.

Can Mono Be Confused for Lymphoma?

This is not usually the case, but it is possible. An atypical clinical presentation of mono occasionally results in a lymph node or tonsillar biopsy. What the pathologist sees on the slide looks a lot like lymphoma. If it is truly lymphoma, however, other tests will bring this to light.

Which Viruses Cause Cancer, Then?

The American Cancer Society has a page devoted to this question, including some viruses that are rarer in the United States.

Human papillomavirus (HPV) and hepatitis B and C viruses are two of the most common cancer-connected viruses, but there are important caveats to go through—once again, not every individual infected by these viruses necessarily develops cancer.

More than 40 types of genital HPV can be passed on through sexual contact. Of these, only about a dozen of these types are known to cause cancer. A few types of HPV are the main causes of cervical cancer, the second most common cancer among women worldwide.

With hepatitis viruses, chronic infections increase the risk of liver disease and cancer, however, if detected, some of these risks can be reduced with medical management of the infections.

The HIV virus that causes acquired immune deficiency syndrome (AIDS), doesn’t seem to cause cancers directly; however, HIV infection increases a person’s risk of several cancers, some of which are linked to other viruses. HIV infects helper T-cells, or lymphocytes, which are a type of white blood cell. This weakens the body’s immune system, which can open the door for some other viruses including HPV, which, as discussed above, might lead to cancer.

A Word From Verywell

If you have acquired a viral infection such as mononucleosis, it is important to get through the acute infection first and to become aware of some of the more common complications in this setting. If you are concerned about the potential long term implications of having been diagnosed with EBV, talk to your healthcare provider, who can help put this risk in perspective.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Epstein-Barr virus and infectious mononucleosis.

  2. American Cancer Society. Viruses that can lead to cancer.

  3. Louissaint A, Ferry JA, Soupir CP, Hasserjian RP, Harris NL, Zukerberg LR. Infectious mononucleosis mimicking lymphoma: distinguishing morphological and immunophenotypic features. Mod Pathol. 2012;25(8):1149-1159. doi:10.1038/modpathol.2012.70

  4. NYU Langone Health. Types of human papillomavirus.

  5. National Cancer Institute. HIV infection and cancer risk.

Additional Reading

By Tom Iarocci, MD
Tom Iarocci, MD, is a medical writer with clinical and research experience in hematology and oncology.