We describe the production and characterization of a novel monoclonal antibody (MAb) that recognizes a human endothelial cell antigen expressed mainly in inflamed and malignant disease states. We have used immunohistochemistry to determine the spectrum of reactivity of this MAb compared with that of a MAb to factor VIII-related antigen (MAb FVIII). MAb 4A11 does not react with several myeloid or lymphoid cell lines or with peripheral blood cells. Unlike MAb FVIII, MAb 4A11 does not react with platelets. MAb 4A11 reacts with most vascular endothelial cells in lymphoid tissue but with few (< 10%) endothelial cells in thymus, spleen, liver, lung, adrenal gland, placenta, testes, and skin. MAb 4A11 detects endothelial cells in diseased tissues such as rheumatoid and osteoarthritic synovium and psoriatic skin. Vascular endothelial cells in both adrenal tumors and cutaneous Kaposi's sarcomas lesions are MAb 4A11 reactive. In vitro the 4A11 antigen is not detectable on cultured human umbilical vein endothelial cells and its expression is not induced on these cells by treatment with lipopolysaccharide, interferon-gamma, interleukin-1 and -6, or tumor necrosis factor-alpha. However, in an in vivo model of allergic contact dermatitis the 4A11 antigen is upregulated differentially from other endothelial markers such as E-selectin, vascular cell adhesion molecule-1, and intercellular adhesion molecule-1. In this dermal model of inflammation, poison ivy extract is applied to the skin and biopsies taken at 0, 6, and 24 hours. In addition to focal keratinocyte expression, 4A11 antigen is found on 11% of dermal endothelial cells at time 0 and antigen expression increases with time until 24 hours, when 4A11 antigen is present on 63% of the endothelial cells. Using thin layer chromatography, MAb 4A11 reacts with the H-5-2 [Fuc alpha 2Gal beta 4GlcNAc beta 3Gal beta 4Glc beta 1Cer] and Lewis(y)-6 [Fuc alpha 2Gal beta 4(Fuc alpha 3)GlcNAc beta 3Gal beta 4-Glc beta 1Cer] blood group glycolipids. The presence of the novel 4A11 antigen in inflamed and malignant tissues containing many blood vessels and its differential upregulation in allergic contact dermatitis may signify an important function for this antigen in the inflammatory process.