It's basically an Americanized version of Fettucine Alfredo.
People make a meal of it, with salad, but it's also a darn good side with roast beef.
A little truffle oil makes for an upscale Mac and Cheese. I had that once in a very fancy restaurant, baked in individual pottery ramekin/mugs with shaved truffle on top. Quite effete and entirely edible.