Pneumomediastinum after acute lymphoblastic leukemia and chemotherapy?

Pneumomediastinum, pneumorachis and subcutaneous emphysema are frequently benign and most commonly result from air escaping from the upper respiratory tract, intrathoracic airways, or gastrointestinal tract. Gas can also be generated by certain infections or reach the mediastinal space from outside air after trauma or surgery. In the article presented by Showkat et al a 14-year-old male patient with acute lymphoblastic leukemia (ALL) under chemotherapy developed pneumomediastinum, pneumorachis and subcutaneous emphysema. In the author's opinion, these complications were caused by ALL or chemotherapy that progressed to severe respiratory failure until the patient finally died in the intensive care unit. I would like to underline some important points, which have been raised following a paper published in the October issue of World Journal of Clinical Cases.