Enter the Necropolis of the Firstborn.
Pursue Lilith.
Destroy the Tumors of Hatred blocking the path forward.
Slay the final Tumor of Hatred to fully uncover the exit.
Pursue Lilith.
Slay Lilith's Lament.
Speak with the Knight Penitent.
Pursue Lilith.
Inspect Lilith's Blood Petals.

This video shows how to do Descent Quest Diablo 4.
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