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Place macaroni in a medium saucepan or skillet and add just enough cold water to cover. Add a pinch of salt and bring to a boil over high heat, stirring frequently. Continue to cook, stirring, until water has been almost completely absorbed and macaroni is just shy of al dente, about 6 minutes.
Immediately add evaporated milk and bring to a boil. Add cheese. Reduce heat to low and cook, stirring continuously, until cheese is melted and liquid has reduced to a creamy sauce, about 2 minutes longer. Season to taste with more salt and serve immediately.