4 year old with enlarged tonsil

About 6 months ago the dentist told me that my 4-year old daughter has large tonsils. She also has a submucous cleft palate.Recently she was seen at a routine doctors appointment involving her cleft and the doctor seemed concerned that her tonsils were still large. He said that the left one was bigger than the other and that she also had fluid in her left ear as well as a small lymph node behind her ear. He refered us to an ENT doctor and gave us the impression that this could be a malignancy. My daughter has not complained of feeling sick or anything like that. occaisionaly she says she has a sore throat, but never anything significant. I am panicking right now because everything I find online says this could be lymphoma! Is this possible? I am terrified of my little girl having something wrong with her. please help!

[J.M. Keyes, MD]

Hi there,
From what you have told me, I would be very surprised if malignancy is a concern.  It is not uncommon for children to have large tonsils, and if they are leading to complications such as ear infections (which may be the concern if she has fluid behind her drum), it may be reasonable to consider tonsillectomy.  I don't know the whole story, but I think your daughter's MD probably just wants an opinion about whether surgery is a good option for her rather than monitoring.
Don't panic- even if the concern was something more worrisome, all you can do at this point is keep the appointment as scheduled- make sure when you see the ENT you clarify what the concern was, and feel comfortable that you have all of your questions answered when you leave.
Best of luck,
JMK MD