Clinical genetics returned a VOUS to four patient families meeting these criteria, including an ITK (p.V175V) mutation in a 7-year-old girl with Hodgkin lymphoma and Epstein-Barr virus, an SDHC (p.G75D) mutation was found in a 12-year-old boy with ALL, a DICER1 (p.D609Y) mutation in an 18-year-old boy with ALCL, and an APC (p.V1822D) mutation in a 7-year-old boy with Ewing sarcoma. Here, SDHC is linked to acute lymphoblastic leukemia.