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English: F1: Tongue atrophy due to transthyretin-related familial amyloid polyneuropathy mimicking amyotrophic lateral sclerosis(A) Marked tongue atrophy—note the furrowing of the lateral aspects of the tongue. Marked fasciculations were noted on examination along with muscle weakness (not shown). (B) A photomicrograph of a minor salivary gland biopsy showing an immunoperoxidase staining for transthyretin (TTR) (dark brown). Diffuse deposition of TTR-positive amyloid is seen in these glands. The patient did not meet inclusion criteria for the ongoing antisense oligonucleotide trial in familial amyloid polyneuropathy secondary to markedly abnormal neuropathy impairment score.