270,000 miles? Could it be a broken engine mount? I'd think you'd be on your 3rd set by now.
I've done far more than three sets. Probably more like ten. The territory around here is very heavy on washboard and ruts. It just tears through engine mounts. I've also had to re-weld my spare tire carrier, driver's seat mounting, and exhaust manifolds multiple times each.
Anyway, the current engine and transmission mounts are brand new.
Back on the hunt, my current plan is to remove everything I can, and simplify the problem. I've removed the front battery and battery box (have a second battery in the back that can run the truck), glove compartment, front passenger chair, steering damper, torsion bar, and bumper. The sound is still there, but at least I can see around easier!