The 391 truck blocks have a different diameter for the lower distributor shaft, down near where the oil pump driveshaft fits in. Ford used to make a bushing that would press into that hole in the block and allow a standard FE distributor to be used, but they've been unavailable for a while now. You could probably have a bronze bushing machined to fit; no big deal, I guess. Some of those 391 truck blocks are really thick, I've got one like that. Mine could easily be bored to 4.13" (428 size) based on the sonic numbers.