Huang HL, Lee MR, Liu CJ, et al. - Researchers assessed clinical features, outcome, and predictors of radiographic progression in patients with nontuberculous mycobacterium (NTM)-pulmonary disease (PD) and multiple culture-negative sputum samples but culture-positive bronchoscopic samples. They examined patients having negative NTM culture from ≥ 2 expectorated sputum samples within the 3 months before bronchoscopy diagnosis of NTM-PD between 2009 and 2017. Male gender, body mass index < 18.5 kg/m², use of inhaled corticosteroids, and acid-fast smear grade ≥2 of index bronchoscopic samples were all identified as independent predictors of radiographic progression. Experts noted that radiographic progression within 2 years was evident in one-fourth of overall patients with bronchoscopy-diagnosed NTM-PD. Those carrying the aforementioned predictors demonstrated even higher risk, immediate treatment or close monitoring was advised. The optimal option for others may include conservative management by regular microbiological monitoring for sputum samples and image follow-up.