Semantic and syntactic contributions to processing of mass and count nouns were assessed by examining the performance of a patient suffering from a pure semantic deficit. Semantic and syntactic processing was evaluated on grammaticality judgement and sentence-picture matching tasks, respectively, where each task involved mass and count readings of metonymic nouns. While the patient did not show impaired performance on the grammaticality judgment task, he manifested difficulties in making mass/count distinctions in the sentence-picture matching task. It is thus argued that while distributionally the mass/count distinction may be established on a purely syntactic basis, cognitive processing of mass/count information requires both intact syntactic and semantic knowledge.