Pediatric Hematology and Oncology, 25:217–226, 2008 Copyright C  Informa Healthcare USA, Inc. ISSN: 0888-0018 print / 1521-0669 online DOI: 10.1080/08880010701884675 Case Report GRANULOMATOUS REACTION IN MEDIASTINAL B-CELL NON-HODGKIN LYMPHOMA AND INTRACARDIAC THROMBOSIS Funda C ¸ orapc ¸ ioglu, MD, Evic ¸ Zeynep Bas ¸ar, MD, and Atalay Demirel, MD ✷ Kocaeli University, Department of Pediatric Oncology, Kocaeli, Turkey Nagihan Inan, MD ✷ Kocaeli University, Department of Radiology, Kocaeli, Turkey Kadir Babao ˘ glu, MD ✷ Kocaeli University, Department of Pediatric Cardiology, Kocaeli, Turkey Hasan Karakurt, MD ✷ Kocaeli University, Department of Pediatric Oncology, Kocaeli, Turkey Evrim Kus ¸ , MD ✷ Kocaeli University, Department of Pathology, Kocaeli, Turkey Gorkem Aksu, MD ✷ Kocaeli University, Department of Radiation Oncology, Kocaeli, Turkey ✷ Epithelioid cell granulomas may be associated with several neoplasms. Lymphomas may mimic or are associated with epithelioid granulomas. In this article the authors report a child with granulomatous reaction in B cell non-Hodgkin lymphoma and intracardiac thrombosis. Although cancer alone is a risk factor for thromboembolism, thrombosis is a multifactorial disorder with both hereditary and acquired risk factors. This is the first reported case of intracardiac thrombosis with MTHFR A1298C and factor XIII V34L mutations together with granulomatous reaction in non-Hodgkin lymphoma. Keywords B-cell non-Hodgkin lymphoma, child, factor XIII V34L, granulomatous reaction, intracardiac thrombosis, MTHFR mutation B-cell non-Hodgkin lymphomas (Burkitt and non-Burkitt lymphomas) are the most frequently seen type of lymphomas in childhood [1]. They can be differentiated from other small round cell tumors by their typical histopathological and immunohistochemical features [2]. The presence Received 26 June 2007; accepted 9 November 2007. Address correspondence to Funda C ¸ orapc ¸ioglu, MD, Assoc. Prof. in Pediatric Oncology, Cumhuriyet Mah. Mısır Sok, EKAS yapı koop. B blok, Kat:1, Da:1, Izmit-Kocaeli, Turkey. E-mail: fundacorapcioglu@yahoo.com 217