Instructions: Preheat oven to 350 degrees F. In a large saucepan, heat 5 quarts of salted water to a rolling boil. Cook pasta until tender, about 8-10 minutes, stirring occasionally to prevent sticking. Meanwhile, add milk to a medium saucepan. In a separate bowl, combine flour, sage, salt and pepper. Whisk ingredients gradually into milk to prevent lumps. Heat mixture, stirring constantly until it thickens and just begins to boil. Add American cheese, stir and remove from heat when cheese is melted. Add a dash of hot pepper sauce (optional). Drain pasta and add to cheese sauce. Butter an 8-inch square baking dish and pour pasta mixture into dish. Spread evenly, top with Cheddar cheese. Bake uncovered for 20-25 minutes until hot and bubbly, serve at once.

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