Dr. Greene, our 7 month old daughter Elise has had swollen lymph glands in the back of her neck and head for about 3 months. They said that she could be getting over an infection (she has only been sick once and that was last week). Well, they have not gotten any smaller, and her hemoglobin was 11.3. The doctors think it is nothing. Correct me if I am wrong, but this sounds much more serious.

She is in the 95th percentile for length, but 50th percentile for weight. She has a humongous appetite, but is very thin. She is active and has been pulling herself up and standing alone along furniture since she was 6 months old. She has always been a happy, healthy baby.

I have looked up these conditions on the net (anemia, swollen glands) and found them similar to those of lymphocytic leukemia. What type of tests need to be run on her to rule this out? Also what other problems could these symptoms indicate?

After losing my mother to cancer at a very young age due to initial misdiagnosis, I do not want to take any chances with my beautiful little girl. When my mother went in with pain in her liver area, they didn't even think of cancer. They sent her home with pain pills only to find a few months later it was cancer. By then it was too late. That is also why I am so worried. Please give me all the information you can.

Almost every day, Shelley, concerned parents ask me about lumps in their children's necks or scalps. Most of the time, these turn out to be normal. Occasionally, though, they are an early sign of a serious infection or malignancy. No wonder, then, lymph nodes are such a cause of concern -- particularly for those who have had a previous experience with cancer.

All of us have hundreds of lymph nodes scattered throughout our bodies as a critical part of our immune systems. This network of nodes functions as a powerful, intelligent filtration system to keep the insides of our bodies clean and healthy.

Tiny vessels called lymph vessels carry germs, foreign particles, and unhealthy or malignant cells to the lymph nodes, where they are trapped. Active lymph nodes enlarge as they attempt to destroy the unwelcome material.

The lymph nodes also function as schools. Lymphocytes, a type of white blood cell, study the foreign material so that they can produce antibodies, killer cells, and other substances to protect the body from the threat.

Sometimes the lymph nodes are overwhelmed in the process. Our defenders can be taken over by a cancer or an infection. These enlarged nodes can become a refuge where the invaders can hide and proliferate.

In a newborn infant, the lymph nodes are often small enough and soft enough not to be felt. But by the time a baby is several months old, healthy, growing, learning lymph nodes are frequently obvious enough to be noticed by parents -- to their alarm.

When evaluating enlarged lymph nodes the first consideration is whether these nodes are localized (in one or two adjacent regions of the body) or generalized (spread throughout the body, often including the spleen -- the largest lymph node -- which is found just under the rib cage in the left upper part of the abdomen). Generalized enlarged lymph nodes suggest that the body is responding to a whole-body problem, such as an infection (bacterial, viral, or fungal), an autoimmune disease (arthritis or lupus), a drug reaction, or a malignancy such as leukemia. The infection might be very mild, or might be as serious as HIV.

Localized enlarged lymph nodes are responding to events in the part of the body filtered by those nodes. A scratch on the finger can produce swollen nodes at the elbow and /or the armpit. Minor trauma to the foot is filtered by nodes behind the knee and in the groin.

The localized nodes most often noticed by parents are those around the head (especially near the base of the skull) and neck.