Xray showed coarse interstitial lung markings. no acute process identified. no significant changes from prior. random episodes of mild shortness of breath for a year. is this likely ild? any other more favorable possibilities?

All laboratory/imaging results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Talk to the doctor who ordered the tests. Wish you good health!

You may have interstitial lung disease in view of those chest X-Ray findings. Have you been advised to have a chest ct scan? I recommend consulting a pulmonologist for evaluation, advice and follow-up. Appropriate testing will be done.

When was the prior CXR? If more than 1 year ago- a bit stable.Hhave autoimmune disease or worked with asbestosis, silicon, or had prior infections, asthma, smoking? Would follow up with your doctor consider pulmonary function testing , echo to check for pulmonary artery pressure ,if needed CT and biopsy . https://my.clevelandclinic.org/health/diseases/17809-interstitial-lung-disease

X-rays are difficult to interpret without knowing the clinical situation fully. This x-ray does not apparently show a definite cause of your shortness of breath. Further testing would be needed to determine if you actually have interstitial lung disease. see your primary doctor or a pulmonologist for the next steps. Good luck.