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Fig. 4D. —39-year-old woman with benign papilloma revealed at core needle biopsy that was upgraded to atypical papilloma at excisional biopsy. Photograph of histologic specimen from excisional biopsy shows intraductal papilloma with atypia. Punched-out spaces and monotonous cytology are shown in this high-power view. Elsewhere on specimen, papilloma shows only epithelial hyperplasia. Because atypical area is only focal, diagnosis is atypical papilloma. (H and E, x100)