We describe a 59-year-old woman, M.T., with a progressive language impairment and neuroimaging findings of decreased perfusion (SPECT) and focal atrophy (MRI) in the left temporal region. The most prominent feature of her cognitive profile was a profound and progressive impairment in naming. In spite of this, she performed normally on tests of semantic processing and phonological output. Her spontaneous speech was fluent with preserved syntax and articulation but with notable word-finding problems. All other cognitive abilities were relatively stable and intact. These features are not typical of either fluent or non-fluent forms of neurodegenerative language disturbance. The cognitive mechanisms that may underlie this case are discussed.